Individual provider Active NPI

James W. Manock, LCSW

  • Clinical Social Worker
  • Orland Park, IL
National Provider Identifier
1659409712
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013567 Issued in IL
Practice address
62 Orland Square Dr
Suite 006
Orland Park, IL 60462-6546
Phone
(708) 941-1077
Fax
(708) 810-9513
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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 149.013567 IL Primary

Addresses

Primary practice location

62 Orland Square Dr
Suite 006
Orland Park, IL 60462-6546

Mailing address

PO Box 1031
Oak Forest, IL 60452-7031
Phone (708) 941-1077

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.013567ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1659409712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1031",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604527031",
            "telephone_number": "708-941-1077",
            "fax_number": "708-810-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 ORLAND SQUARE DR",
            "address_2": "SUITE 006",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604626546",
            "telephone_number": "708-941-1077",
            "fax_number": "708-810-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOCK",
        "first_name": "JAMES",
        "middle_name": "W.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; 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.