Carliann Pentz

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149025072 Issued in IL

Practice address

540 Michigan Ave
Evanston, IL 60202-3037

Phone

(815) 529-3665

NPI assigned

Sep 15, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, CO2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Sondermind PCGroup PAC ID 0547795791, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Sondermind PC

  • Clinical Social Worker
  • San Jose, CA
  • NPI 1003646977

  IL

  Medicare reassignment Care Compare group NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442
  Medicare reassignment NPD
• New World Psychology LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Evanston, IL
  • NPI 1982231759
  NPD (past)

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669334400000",
    "number": "1629790761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 MICHIGAN AVE APT H3",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023037",
            "telephone_number": "815-529-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 MICHIGAN AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023037",
            "telephone_number": "815-529-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTZ",
        "first_name": "CARLIANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150109067",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149025072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynn Peltzer-Miller, MSN, RN, CNL
• Mehul Pema, DO
• Aimee Jane Aledia Pena, RPT
• Veronica Pena, LCPC
• Rebecca Peng, PHARM D
• Nicole Penz, LCSW
• Angela Perez-Martinez
• Marcella Victoria Perez, DO
• Ramoncito Perez, APN- CRNA
• Adem Perezic, RN

• Clinical Social Worker in Evanston, IL
• Providers in Evanston, 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 Nov 25, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.