Individual provider Active NPI

Lori Hunsaker Smith

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1639647209
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149003588 Issued in IL
Practice address
2650 S California Ave
Chicago, IL 60608-5146
Phone
(773) 674-7202
NPI assigned
Nov 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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 149003588 IL Primary

Addresses

Primary practice location

2650 S California Ave
Chicago, IL 60608-5146

Mailing address

8948 S Mozart Ave
Evergreen Park, IL 60805-1256
Phone (312) 504-7289

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
I20240627002979 IL Practitioner - Mental Health Counselor 2961946280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cognitive Clinic P CGroup PAC ID 9032653357, 3 clinicians

Practice addresses (Care Compare)

9944 S Roberts Rd
Suite 202
Palos Hills, IL 60465-1558
Phone (708) 586-9050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149003588ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cognitive Clinic P C CurrentSince May 16, 2024 Accepting new patients

Locations

9944 S Roberts Rd
Ste 202
Palos Hills, IL 60465
Phone (708) 586-9050

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1639647209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8948 S MOZART AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051256",
            "telephone_number": "312-504-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606085146",
            "telephone_number": "773-674-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LORI",
        "middle_name": "HUNSAKER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149003588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.