Individual provider Active NPI

Brian Peter McIntosh, LCSW, CADC

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1487062352
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.021480 Issued in IL
Practice address
3340 W Potomac Ave Unit 2F
Chicago, IL 60651-2324
Phone
(312) 380-9676
NPI assigned
Jul 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.021480 IL Primary

Addresses

Primary practice location

3340 W Potomac Ave Unit 2F
Chicago, IL 60651-2324

Mailing address

3340 W Potomac Ave Unit 2F
Chicago, IL 60651-2324
Phone (312) 380-9676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251223000468 IL Practitioner - Clinical Social Worker 8820583248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baal Perazim Wellness IncGroup PAC ID 7618218587, 20 clinicians

Practice addresses (Care Compare)

3416 S Halsted St
Chicago, IL 60608-6708
Phone (773) 296-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.021480ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Baal Perazim Wellness, Inc CurrentSince Sep 1, 2025 Accepting new patients

Locations

3916 N Broadway St
Chicago, IL 60613
Phone (773) 649-3099

2835 N Sheffield Ave
Ste 500
Chicago, IL 60657
Phone (773) 525-6955

3416 S Halsted St
Chicago, IL 60608
Phone (773) 451-9444

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1487062352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 W POTOMAC AVE UNIT 2F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512324",
            "telephone_number": "312-380-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 W POTOMAC AVE UNIT 2F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512324",
            "telephone_number": "312-380-9676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "BRIAN",
        "middle_name": "PETER",
        "credential": "LCSW, CADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-23",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.