Individual provider Active NPI

Michelle Ann KRC Gerlach, LCSW, MA

  • Clinical Social Worker
  • Crystal Lake, IL
National Provider Identifier
1730647090
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.021374 Issued in IL
Practice address
8600 US Highway 14 Ste 220a
Crystal Lake, IL 60012-2711
Phone
(224) 338-6038
NPI assigned
Mar 6, 2019
Last updated
Dec 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.021374 IL Primary
Social Worker 104100000X 150.102806 IL

Addresses

Primary practice location

8600 US Highway 14 Ste 220a
Crystal Lake, IL 60012-2711

Mailing address

215 Fenimore Rd
Crystal Lake, IL 60014-7377
Phone (247) 159-6302

Other practice location 1

210 Crystal St Ste C
Cary, IL 60013-2096
Phone (224) 338-6038

Other practice location 2

1345 Wiley Rd Ste 124
Schaumburg, IL 60173-4356
Phone (224) 715-9630

Other names 1

  • Michelle A KRC Former name

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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190916003063 IL Practitioner - Clinical Social Worker 8628307634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8600 US Hwy 14
Suite 220a
Crystal Lake, IL 60012-2706
Phone (224) 338-6038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
150.102806ILMDSocial Worker
149.021374ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Equinox Counseling Center LLC CurrentSince Aug 1, 2022 Accepting new patients
Eannarino Therapeutic Services LLC Past Accepting new patients

Locations

210 Crystal St
Ste C
Cary, IL 60013
Phone (224) 338-6038

8600 US Highway 14
Ste 220A
Crystal Lake, IL 60012
Phone (224) 338-6038

1345 Wiley Rd
Ste 124
Schaumburg, IL 60173
Phone (847) 772-7709

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

NPI Registry JSON

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1730647090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 FENIMORE RD",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147377",
            "telephone_number": "247-159-6302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 US HIGHWAY 14 STE 220A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600122711",
            "telephone_number": "224-338-6038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Crystal St Ste C",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "IL",
            "postal_code": "600132096",
            "country_code": "US",
            "telephone_number": "224-338-6038",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1345 Wiley Rd Ste 124",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601734356",
            "country_code": "US",
            "telephone_number": "224-715-9630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERLACH",
        "first_name": "MICHELLE",
        "middle_name": "ANN KRC",
        "credential": "LCSW, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021374",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.102806",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "KRC",
            "middle_name": "A",
            "credential": "LCSW, MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.