Pamela Annette Kostecki, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.012389 Issued in IL

Practice address

203 N Ottawa St
Joliet, IL 60432-4006

Phone

(815) 724-1156

Fax

(815) 723-3452

NPI assigned

Nov 29, 2010

Last updated

Nov 29, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Catholic Charities of the Diocese of Joliet

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Joliet, IL
  • NPI 1609953223
  NPD (past)

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290988800000",
    "number": "1508168477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N OTTAWA ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604324006",
            "telephone_number": "815-724-1156",
            "fax_number": "815-723-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N OTTAWA ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604324006",
            "telephone_number": "815-724-1156",
            "fax_number": "815-723-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTECKI",
        "first_name": "PAMELA",
        "middle_name": "ANNETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-29",
        "last_updated": "2010-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "9932230",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David K Koopmann, LCPC, ED. D.
• Christopher J. Kopacz, PTA
• Nicole Christine Koren, MA
• Kadiatu S Koroma
• Christy Koshy, DPT
• Dawn R Kovacik, M.A
• Christopher Kovacs, PTA
• Chad Kovash, P.A.
• Jennifer Gail Kowalkowski, MA, LPC
• Joanne C. Kozak, CRNA

• Clinical Social Worker in Joliet, IL
• Providers in Joliet, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.