Individual provider Active NPI

Marla Golden Kolovitz, LCSW

  • Clinical Social Worker
  • North Riverside, IL
National Provider Identifier
1598514440
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.026462 Issued in IL
Practice address
2938 Desplaines Ave
North Riverside, IL 60546-1852
Phone
(708) 268-0725
NPI assigned
May 14, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.026462 IL Primary

Addresses

Primary practice location

2938 Desplaines Ave
North Riverside, IL 60546-1852

Mailing address

2938 Desplaines Ave
North Riverside, IL 60546-1852
Phone (708) 268-0725

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
149.026462ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1598514440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2938 DESPLAINES AVE",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461852",
            "telephone_number": "708-268-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2938 DESPLAINES AVE",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461852",
            "telephone_number": "708-268-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLOVITZ",
        "first_name": "MARLA",
        "middle_name": "GOLDEN",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Riverside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.