Individual provider Active NPI

Elizabeth Piasecki, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1629450986
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149012128 Issued in IL
Practice address
520 N Ridgeway Ave
Chicago, IL 60624-1232
Phone
(773) 265-4307
Fax
(773) 265-4385
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149012128 IL Primary
Psychiatric Hospital Unit 273R00000X

Addresses

Primary practice location

520 N Ridgeway Ave
Chicago, IL 60624-1232

Mailing address

3321 S 61St CT
Cicero, IL 60804-3726
Phone (773) 265-4307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149012128ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1629450986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 S 61ST CT",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608043726",
            "telephone_number": "773-265-4307",
            "fax_number": "773-265-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N RIDGEWAY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606241232",
            "telephone_number": "773-265-4307",
            "fax_number": "773-265-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIASECKI",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012128",
            "primary": true
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.