Individual provider Active NPI

Olivia Espinosa, LCSW

  • Clinical Social Worker
  • Geneva, IL
National Provider Identifier
1700550324
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.022201 Issued in IL
Practice address
28 S 5TH St
Geneva, IL 60134-2111
Phone
(630) 765-3214
NPI assigned
Aug 6, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Anchor Counseling Inc 5 clinicians

Practice addresses (Care Compare)

2700 Keslinger Rd
Suite B
Geneva, IL 60134-4645
Phone (630) 765-3214

43 W043 Campton Hills Rd
Elburn, IL 60119-9435

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20210928003177 IL Practitioner - Clinical Social Worker 1355748666 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.022201ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anchor Counseling Inc. CurrentSince Sep 15, 2021 Accepting new patients
Ronald B Bukowy MD SC PastSince Feb 7, 2017 Accepting new patients

Locations

2700 Keslinger Rd
Ste B
Geneva, IL 60134
Phone (630) 262-1500

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.022201 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

28 S 5TH St
Geneva, IL 60134-2111

Mailing address

968 Hyacynth LN
Bartlett, IL 60103-5748
Phone (224) 723-8912

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 6, 2021.

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1700550324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "968 HYACYNTH LN",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601035748",
            "telephone_number": "224-723-8912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 S 5TH ST",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342111",
            "telephone_number": "630-765-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINOSA",
        "first_name": "OLIVIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.022201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.