Individual provider Active NPI

Christina Marie Geiselhart, LCSW

  • Clinical Social Worker
  • Dixon, IL
National Provider Identifier
1639476120
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015392 Issued in IL
Practice address
325 Illinois RT 2
Dixon, IL 61021-9118
Phone
(815) 284-6611
NPI assigned
Feb 17, 2011
Last updated
Jul 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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 149015392 IL Primary

Addresses

Primary practice location

325 Illinois RT 2
Dixon, IL 61021-9118

Mailing address

704 Parkside Dr
Rockford, IL 61108-3864
Phone (815) 520-1081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MA2 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

Enrollment IDStateProvider typePAC IDDetails
I20130802000854 IL Practitioner - Clinical Social Worker 7012159007 Reassigns benefits to 1 organization
I20260430002523 MA Practitioner - Clinical Social Worker 7012159007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thriveworks Clinical - IllinoisGroup PAC ID 6800263823, 45 clinicians

Practice addresses (Care Compare)

2500 W Higgins Rd
Suite 935
Hoffman Estates, IL 60169-2098
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149015392ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - Illinois CurrentSince Aug 2, 2023 Accepting new patients
Geiselhart Solution Focused Therapy, LLC Clinical Current Accepting new patients
Sinnissippi Centers, Inc. Past Accepting new patients
Sinnissippi Centers, Inc. Past Accepting new patients
Sinnissippi Centers, Inc. Past Accepting new patients
Sinnissippi Centers, Inc. Past Accepting new patients
Sinnissippi Centers, Inc. Past Accepting new patients

Locations

333 N Michigan Ave
Ste 1810
Chicago, IL 60601
Phone (217) 850-1133

2500 W Higgins Rd
Ste 935
Hoffman Estates, IL 60169
Phone (217) 850-1133

Organizations & group practices 8

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": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1639476120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 PARKSIDE DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611083864",
            "telephone_number": "815-520-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 ILLINOIS RT 2",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610219118",
            "telephone_number": "815-284-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEISELHART",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.