Carl Lee Brakman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149002890 Issued in IL

Practice address

800 Main St Ste 210
Antioch, IL 60002-1578

Phone

(847) 903-5604

NPI assigned

Nov 28, 2017

Last updated

Sep 2, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Clinical Psychologists, LTDGroup PAC ID 4981991031, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Associated Clinical Psychologists, LTD

  dba ACP Consultants

  • Clinical Psychologist
  • Park Ridge, IL
  • NPI 1578665147
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1689188716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MAIN ST STE 210",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021578",
            "telephone_number": "847-903-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAIN ST STE 210",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021578",
            "telephone_number": "847-903-5604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAKMAN",
        "first_name": "CARL",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-28",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149002890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beyond Rehab, LLC
• Beau Blumenschein, PHARM.D.
• Daniel J Boarini, D.D.S.
• Danielle Boettcher, LCPC, PHD
• Debora A Boucher, APRN-FPA, CNM
• Danielle Brose, MS, OTR/L
• Linda Mary Brown, PSY.D
• Alyssa Brunner
• Kathleen Buster
• Kristan Cameron, MA., LCPC

• Clinical Social Worker in Antioch, IL
• Providers in Antioch, 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 Sep 2, 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.