Individual provider Active NPI

Linda Carlson, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1609348812
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.019926 Issued in IL
Practice address
845 N Michigan Ave Ste 973W
Chicago, IL 60611-2218
Phone
(312) 651-6255
NPI assigned
Dec 28, 2018
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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 149.019926 IL Primary

Addresses

Primary practice location

845 N Michigan Ave Ste 973W
Chicago, IL 60611-2218

Mailing address

2846 W Summerdale Ave Apt 2W
Chicago, IL 60625-3425
Phone (503) 890-3111

Other practice location 1

320 W Ohio St Ste 3W
Chicago, IL 60654-7887
Phone (773) 897-3197

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190212001795 IL Practitioner - Clinical Social Worker 5294073599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
New York University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revolution PTWL LLCGroup PAC ID 7719115617, 42 clinicians

Practice addresses (Care Compare)

845 N Michigan Ave
Suite 973W
Chicago, IL 60611-2218
Phone (312) 878-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.019926ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Revolution PTWL LLC CurrentSince Jan 2, 2019 Accepting new patients
Managing With Mindfulness, PLLC Past Accepting new patients

Locations

845 N Michigan Ave
Ste 973W
Chicago, IL 60611
Phone (312) 651-6255

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1609348812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2846 W SUMMERDALE AVE APT 2W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253425",
            "telephone_number": "503-890-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 N MICHIGAN AVE STE 973W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112218",
            "telephone_number": "312-651-6255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 W Ohio St Ste 3W",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606547887",
            "country_code": "US",
            "telephone_number": "773-897-3197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "LINDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-28",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.