Courtney Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149008112 Issued in IL

Practice address

1100 Lake St
Suite 201
Oak Park, IL 60301-1015

Phone

(773) 766-7010

NPI assigned

Aug 27, 2013

Last updated

Aug 27, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lutheran Social Services of Illinois

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1063637684

  Clinical

  Medicare reassignment NPD
• Lutheran Social Services of Illinois

  dba Welcoming Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1144613746

  Clinical

  NPD
• Kate Giandonato & Associates

  • Clinical Social Worker
  • Oak Park, IL
  • NPI 1629491394
  NPD (past)

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1619301546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 W CUYLER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606341501",
            "telephone_number": "773-544-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE ST",
            "address_2": "SUITE 201",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011015",
            "telephone_number": "773-766-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "COURTNEY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149008112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imara Cintron
• Anne Elizabeth Ciosek, M.A.CCC-SLP
• Citizens RX, LLC
• CKM Psychological Services PLLC
• Terry Lynn Clarbour, MD
• Sha'Rhonda Clark
• David R Claus, MD
• Deborah Kay Clause, LCSW
• Daniel Clearwater
• Kerstin Clouser, NBC-HWC

• Clinical Social Worker in Oak Park, IL
• Providers in Oak Park, 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 Aug 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.