Individual provider Active NPI

Robert Carty, LCSW, CADC, CCJP

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1568813939
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.009467 Issued in IL
Practice address
867 N Dearborn St
Chicago, IL 60610-3310
Phone
(312) 631-7952
Fax
(312) 943-3530
NPI assigned
Jun 28, 2016
Last updated
Jun 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Clinical Social Worker 1041C0700X 149.009467 IL Primary

Addresses

Primary practice location

867 N Dearborn St
Chicago, IL 60610-3310

Mailing address

867 N Dearborn St
Chicago, IL 60610-3310
Phone (312) 631-7952

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

LicenseStateTypeSpecialty
149.009467ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1568813939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "867 N DEARBORN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606103310",
            "telephone_number": "312-631-7952",
            "fax_number": "312-943-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 N DEARBORN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606103310",
            "telephone_number": "312-631-7952",
            "fax_number": "312-943-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTY",
        "first_name": "ROBERT",
        "credential": "LCSW, CADC, CCJP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.009467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.