Individual provider Active NPI

James J. Cosenza, LCSW, CADC

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1508080862
Registry record updated Aug 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.011466 Issued in IL
Practice address
4753 N Broadway St
Suite 608
Chicago, IL 60640-5266
Phone
(773) 633-6643
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2012

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 149.011466 IL Primary

Addresses

Primary practice location

4753 N Broadway St
Suite 608
Chicago, IL 60640-5266

Mailing address

4753 N Broadway St
Suite 608
Chicago, IL 60640-5266
Phone (773) 633-6643

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
I20070706000215 IL Practitioner - Clinical Social Worker 7416057302 Reassigns benefits to 1 organization
Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inclusive Insight Psychotherapy and ConsultingGroup PAC ID 4880937903, 16 clinicians

Practice addresses (Care Compare)

840 W Irving Park Rd
Suite 302
Chicago, IL 60613-3011
Phone (773) 659-9207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.011466ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inclusive Insight Psychotherapy & Consulting CurrentSince Jan 1, 2020 Accepting new patients

Locations

4753 N Broadway St
Ste 608
Chicago, IL 60640
Phone (201) 803-1420

840 W Irving Park Rd
Ste 302
Chicago, IL 60613
Phone (773) 871-5150

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1508080862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4753 N BROADWAY ST",
            "address_2": "SUITE 608",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405266",
            "telephone_number": "773-633-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4753 N BROADWAY ST",
            "address_2": "SUITE 608",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405266",
            "telephone_number": "773-633-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSENZA",
        "first_name": "JAMES",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.