Individual provider Active NPI

Stephen Thomas Carlson, LCSW

  • Clinical Social Worker
  • Vernon Hills, IL
National Provider Identifier
1609519578
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3 W Hawthron Parkway
Suite 120
Vernon Hills, IL 60061-1441
Phone
(847) 680-2715
Fax
(847) 680-3832
NPI assigned
Apr 18, 2022
Last updated
Mar 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 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 IL Primary

Addresses

Primary practice location

3 W Hawthron Parkway
Suite 120
Vernon Hills, IL 60061-1441

Mailing address

900 Technology Way Ste 320
Libertyville, IL 60048-5364
Phone (847) 680-2715

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
I20240410002924 IL Practitioner - Clinical Social Worker 1658719588 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CMC Healthcare LLCGroup PAC ID 4688039209, 133 clinicians

Practice addresses (Care Compare)

6840 W Touhy Ave
Niles, IL 60714-4520
Phone (847) 647-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Healthcare LLC CurrentSince Nov 19, 2024 Accepting new patients
Counseling Connection Inc. Clinical CurrentSince Mar 28, 2024 Accepting new patients
Inspire Counseling Center, LLC PastSince Feb 1, 2023 Accepting new patients

Locations

2451 W Touhy Ave
Chicago, IL 60645
Phone (312) 593-5599

2201 Main St
Evanston, IL 60202
Phone (847) 905-3000

900 Technology Way
Ste 320
Libertyville, IL 60048
Phone (847) 680-2715

6840 W Touhy Ave
Niles, IL 60714
Phone (317) 873-7450

3 W Hawthorn Pkwy
Ste 120
Vernon Hills, IL 60061
Phone 8476802715 ext. 283

Organizations & group practices 3

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": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1609519578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 TECHNOLOGY WAY STE 320",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485364",
            "telephone_number": "847-680-2715",
            "fax_number": "847-680-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 W HAWTHRON PARKWAY",
            "address_2": "SUITE 120",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611441",
            "telephone_number": "847-680-2715",
            "fax_number": "847-680-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "STEPHEN",
        "middle_name": "THOMAS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-18",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon Hills, IL

Sources for this page

Verify at the official NPI Registry.