Ashley Brooke Carson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.005390 Issued in IL

Practice address

1779 RFD
Long Grove, IL 60047-7314

Phone

(224) 500-1774

NPI assigned

Oct 6, 2016

Sex

Female

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

Other, 1991

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Long Grove Center for Emotional Health LLCGroup PAC ID 0042562886, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Long Grove Center for Emotional Health LLC

  • Mental Health Counselor
  • Long Grove, IL
  • NPI 1790220820
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1740730399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1779 RFD",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600477314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1779 RFD",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600477314",
            "telephone_number": "224-500-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "ASHLEY",
        "middle_name": "BROOKE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.005390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roseanne Marie Boldt, PSYD
• Lana Bratko, FNP-C
• Sara Buresh, OTR/L
• Lindley Caldwell, MS, OTR/L
• Mark L Cannon, DDS, MS
• Central Speech and Language Clinic, Inc.
• Briana Marie Certa, OTD
• Sarah Chang
• Chmela Fluency Center, Inc.
• Kristin A Chmela, M.A., CCC-SLP, BRFS

• Clinical Social Worker in Long Grove, IL
• Providers in Long Grove, 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 Oct 6, 2016; 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.