Active NPI
Cheryl Pristas, LCSW, ICDVP
- Clinical Social Worker
- Joliet, IL
National Provider Identifier
1508257601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149017277
- Practice address
- 1150 Essington Rd Ste 101
Joliet, IL 60435-8447 - Phone
- (815) 823-8460
- Fax
- (815) 823-8461
- NPI assigned
- Feb 10, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149017277 | IL | Primary |
Addresses
Primary practice location
1150 Essington Rd Ste 101
Joliet, IL 60435-8447
Mailing address
1150 Essington Rd Ste 101
Joliet, IL 60435-8447
Phone (815) 823-8460
Other practice location 1
25457 Colligan St
Manhattan, IL 60442-1418
Phone (815) 955-8742
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149017277 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1508257601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1150 ESSINGTON RD STE 101",
"city": "JOLIET",
"state": "IL",
"postal_code": "604358447",
"telephone_number": "815-823-8460",
"fax_number": "815-823-8461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 ESSINGTON RD STE 101",
"city": "JOLIET",
"state": "IL",
"postal_code": "604358447",
"telephone_number": "815-823-8460",
"fax_number": "815-823-8461"
}
],
"practiceLocations": [
{
"address_1": "25457 Colligan St",
"address_purpose": "LOCATION",
"city": "Manhattan",
"state": "IL",
"postal_code": "604421418",
"country_code": "US",
"telephone_number": "815-955-8742",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRISTAS",
"first_name": "CHERYL",
"credential": "LCSW, ICDVP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-10",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149017277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.