Individual provider Active NPI

Agata Daria Kubinska, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1790439388
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149024157 Issued in IL
Practice address
1 E Erie St Ste 525-5050
Chicago, IL 60611-2740
Phone
(312) 714-6777
NPI assigned
Feb 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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 149024157 IL Primary

Addresses

Primary practice location

1 E Erie St Ste 525-5050
Chicago, IL 60611-2740

Mailing address

1 E Erie St Ste 525-5050
Chicago, IL 60611-2740
Phone (312) 714-6777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 21, 2025 through May 21, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149024157ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dar Counseling, LLC CurrentSince Mar 13, 2022 Accepting new patients

Locations

1 E Erie St
Ste 5255050
Chicago, IL 60611
Phone (312) 714-6777

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": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1790439388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E ERIE ST STE 525-5050",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112740",
            "telephone_number": "312-714-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E ERIE ST STE 525-5050",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112740",
            "telephone_number": "312-714-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBINSKA",
        "first_name": "AGATA",
        "middle_name": "DARIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149024157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.