Organization Active NPI

Kari Sandy Counseling Corporation

  • Clinical Social Worker
  • Roselle, IL
National Provider Identifier
1609310523
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149013042 Issued in IL
Legal business name
KARI SANDY COUNSELING CORPORATION
Practice address
975 E Nerge Rd
Suite W100-E
Roselle, IL 60172-4804
Phone
(773) 263-7796
NPI assigned
Dec 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Authorized official

Name
Mrs. Kari Sandy, LCSWNPI 1689831430
Title
President
Phone
(773) 263-7796

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 149013042 IL Primary

Addresses

Primary practice location

975 E Nerge Rd
Suite W100-E
Roselle, IL 60172-4804

Mailing address

556 Lincoln St
Roselle, IL 60172-1003
Phone (773) 263-7796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180521003227 IL Part B Supplier - Clinic/Group Practice 4082979059 Receives reassigned benefits from 1 practitioner
Practice locations: Roselle, IL

National Provider Directory

National Provider Directory

Locations

975 E Nerge Rd
Ste W100E
Roselle, IL 60172
Phone (773) 263-7796

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1609310523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 LINCOLN ST",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601721003",
            "telephone_number": "773-263-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E NERGE RD",
            "address_2": "SUITE W100-E",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601724804",
            "telephone_number": "773-263-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARI SANDY COUNSELING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "SANDY",
        "authorized_official_first_name": "KARI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-263-7796",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roselle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.