Individual provider Active NPI

Michael J. Pearson, MSW, LCSW

  • Clinical Social Worker
  • Lake Zurich, IL
National Provider Identifier
1780736843
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149004449 Issued in IL
Practice address
765 Ela Rd
Suite 211
Lake Zurich, IL 60047-6305
Phone
(847) 438-5336
Fax
(847) 540-0958
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149004449 IL Primary

Addresses

Primary practice location

765 Ela Rd
Suite 211
Lake Zurich, IL 60047-6305

Mailing address

765 Ela Rd
Suite 211
Lake Zurich, IL 60047-6305
Phone (847) 438-5336

Other identifiers 4

IdentifierTypeStateIssuer
2154749OtherTXAETNA PROVIDER #
0005204094OtherTXAETNA PIN
05959OtherMDCIGNA BEHAVIORAL HEALTH #
0004932116OtherILBLUE CROSS BLUE SHIELD PN

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
I20070312000362 IL Practitioner - Clinical Social Worker 9032212097 Practice locations: Lake Zurich, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

765 Ela Rd
Lake Zurich, IL 60047-6305
Phone (847) 438-5336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Catherine J Hunter & Associates LTD Clinical PastSince Jan 25, 2014 Accepting new patients

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1780736843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 ELA RD",
            "address_2": "SUITE 211",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600476305",
            "telephone_number": "847-438-5336",
            "fax_number": "847-540-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ELA RD",
            "address_2": "SUITE 211",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600476305",
            "telephone_number": "847-438-5336",
            "fax_number": "847-540-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149004449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER #",
            "identifier": "2154749",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "0005204094",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH #",
            "identifier": "05959",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PN",
            "identifier": "0004932116",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Zurich, IL

Sources for this page

Verify at the official NPI Registry.