Jessica Marie Caccavallo, MSW, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

150102142 Issued in IL

Practice address

9241 S Il Route 31
Lake in the Hills, IL 60156-1607

Phone

(847) 854-4333

Fax

(847) 854-4334

NPI assigned

Jun 23, 2017

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Your Path Therapeutic Services Inc

  • Clinical Social Worker
  • Westmont, IL
  • NPI 1619688124
  NPD
• Ask US Counseling Services, LLC.

  • Adult Mental Health Clinic/Center
  • Schaumburg, IL
  • NPI 1407443641
  NPD (past)
• Owens & Associates Counseling Therapy Center, LLC

  • Counselor
  • Schaumburg, IL
  • NPI 1962696054
  NPD (past)

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1699295360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 SUMMER BLVD APT 301",
            "city": "LAKEMOOR",
            "state": "IL",
            "postal_code": "600516431",
            "telephone_number": "847-802-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9241 S IL ROUTE 31",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601561607",
            "telephone_number": "847-854-4333",
            "fax_number": "847-854-4334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1305 Wiley Rd Ste 131",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601734354",
            "country_code": "US",
            "telephone_number": "847-854-4333",
            "fax_number": "847-854-4334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CACCAVALLO",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150102142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Brescia
• Sherry Lynn Bresnahan, D.C.
• Brian L. O'Byrn DDS, Ms, LTD. (Algonquin Orthodontics)
• Maxine Magaretta Brown Huffstead, APN -PMHNP-BC
• Klaudia P Burian, NBC-HWC
• Steven A Campau, MD
• Sarah Emily Caraher
• Elizabeth Carlson, SLP
• Carron and Hodack Dental Associates LLC (RidgePointe Dental)
• Richard L Carron, D.D.S.

• Social Worker in Lake in the Hills, IL
• Providers in Lake in the Hills, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.