Carlos Jorge Acosta, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.011623 Issued in IL

Practice address

110 S Johnson St
Suite 212
Woodstock, IL 60098-3259

Phone

(815) 206-0445

Fax

(815) 206-1056

NPI assigned

Sep 5, 2008

Sex

Male

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

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Phoenix Bilingual Services PLLC

  • Community/Behavioral Health Agency
  • Huntley, IL
  • NPI 1730985961
  NPD Authorized official
• McHenry Co. Latino Coalition

  • Community/Behavioral Health Agency
  • Woodstock, IL
  • NPI 1942458781
  NPD (past) Authorized official

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1598913345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S JOHNSON ST",
            "address_2": "SUITE 212",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983259",
            "telephone_number": "815-206-0445",
            "fax_number": "815-206-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S JOHNSON ST",
            "address_2": "SUITE 212",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983259",
            "telephone_number": "815-206-0445",
            "fax_number": "815-206-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "CARLOS",
        "middle_name": "JORGE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-05",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Woodstock, IL
• Providers in Woodstock, 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 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.