Individual provider Active NPI

Sylvia Corcoran, LCSW, CADC, MCED.

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1720113038
Registry record updated Jul 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.011895 Issued in IL
Practice address
618 Library PL
Evanston, IL 60201-2908
Phone
(847) 733-4300
Fax
(847) 733-0390
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 22293 IL
Clinical Social Worker 1041C0700X 149.011895 IL Primary

Addresses

Primary practice location

618 Library PL
Evanston, IL 60201-2908

Mailing address

1128 Maple Ave
Apt. 3B
Evanston, IL 60202-4204
Phone (847) 864-0042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130823001059 IL Practitioner - Clinical Social Worker 5193968162 Reassigns benefits to 1 organization
I20251103001324 IA Practitioner - Clinical Social Worker 5193968162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inclusive Insight Psychotherapy and ConsultingGroup PAC ID 4880937903, 16 clinicians

Practice addresses (Care Compare)

840 W Irving Park Rd
Suite 302
Chicago, IL 60613-3011
Phone (773) 659-9207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22293ILMDAddiction (Substance Use Disorder) Counselor
149.011895ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inclusive Insight Psychotherapy & Consulting CurrentSince Nov 1, 2020 Accepting new patients

Locations

5005 Douglas Ave
Ste 105
Des Moines, IA 50310
Phone (515) 499-8363

840 W Irving Park Rd
Ste 302
Chicago, IL 60613
Phone (773) 871-5150

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1720113038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 MAPLE AVE",
            "address_2": "APT. 3B",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602024204",
            "telephone_number": "847-864-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 LIBRARY PL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012908",
            "telephone_number": "847-733-4300",
            "fax_number": "847-733-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORCORAN",
        "first_name": "SYLVIA",
        "credential": "LCSW, CADC, MCED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "22293",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.