Individual provider Active NPI

Carrie Jean Stelnicki, L.C.S.W.

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1790058543
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.009482 Issued in IL
Practice address
1234 Oak Ave
Evanston, IL 60202-1221
Phone
(773) 386-3859
NPI assigned
Feb 9, 2012
Last updated
Feb 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 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 149.009482 IL Primary

Addresses

Primary practice location

1234 Oak Ave
Evanston, IL 60202-1221

Mailing address

1234 Oak Ave
Evanston, IL 60202-1221
Phone (773) 386-3859

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
I20241122001000 IL Order and Referring Only - Clinical Social Worker 2961937313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.009482ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tapestry 360 Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: carrie.stelnicki.1@27315.direct.athenahealth.com

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, 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": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1790058543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 OAK AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021221",
            "telephone_number": "773-386-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 OAK AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021221",
            "telephone_number": "773-386-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELNICKI",
        "first_name": "CARRIE",
        "middle_name": "JEAN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.009482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.