Stacey Rupolo

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

4845 N Magnolia Ave Apt 2E
Chicago, IL 60640-4725

Phone

(203) 962-2918

NPI assigned

Sep 12, 2022

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

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Brianna Sorensen LCSW PCGroup PAC ID 5092092270, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Brianna Sorensen, LCSW, PC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1588064000
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1598487183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4247 N DAMEN AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183011",
            "telephone_number": "773-234-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 N MAGNOLIA AVE APT 2E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404725",
            "telephone_number": "203-962-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPOLO",
        "first_name": "STACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stacey@practicalmagichealing.org",
            "affiliation": "N",
            "endpointDescription": "professional HIPPA protected email account",
            "address_1": "4845 N Magnolia Ave Apt 2E",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606404725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen J. Rupar, PSY.D.
• Mark Rupasinghe
• Nicholas Rupisan
• Hector Rupitt, LCPC
• Kelly Rupkey
• David Rupp, LCSW
• Fraida Rupp
• Todd Ruppar, PHD, APRN
• Julianne Kathryn Ruppel, D.D.S.
• Stephen Ruppert, LCSW, CADC

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.