Selene Leelam Mehta

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149008544 Issued in IL

Practice address

721 S Quentin Rd
Palatine, IL 60067-6778

Phone

(847) 359-7490

Fax

(847) 359-7525

NPI assigned

Feb 23, 2012

Last updated

Feb 23, 2012By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Jim Brunetti

  • Community/Behavioral Health Agency
  • Palatine, IL
  • NPI 1427448521
  NPD (past)

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1588938427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 N CHARTER HALL DR",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678678",
            "telephone_number": "847-212-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 S QUENTIN RD",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600676778",
            "telephone_number": "847-359-7490",
            "fax_number": "847-359-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "SELENE",
        "middle_name": "LEELAM",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-23",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149008544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Supply Services US LLC (Medical Supplies US)
• Medicus Services, S.C.
• Meditrina Home Health Care Inc
• Sarah Medrys, MSW,LSW
• Medserv Equipment Corp
• Kristin Melendez, FNP-BC
• Melissa Tolman M.S. CCC-SLP (Express Yourself Therapy)
• Lyndsey A Menning, MSPT
• Luke Christian Merrill
• Rebecca Renee Messick, ATS

• Clinical Social Worker in Palatine, IL
• Providers in Palatine, 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 Feb 23, 2012; 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.