Individual provider Active NPI

Kristina Skof

  • Clinical Social Worker
  • Northfield, IL
National Provider Identifier
1801564513
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.027676 Issued in IL
Practice address
405 Central Ave
Northfield, IL 60093-3006
Phone
(847) 441-5600
NPI assigned
Aug 30, 2021
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 149.027676 IL Primary

Addresses

Primary practice location

405 Central Ave
Northfield, IL 60093-3006

Mailing address

405 Central Ave
Northfield, IL 60093-3006
Phone (847) 441-5600

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
I20241021003102 IL Practitioner - Clinical Social Worker 1052843638 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.027676ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Josselyn Center NFP Counselor CurrentSince Sep 4, 2024 Accepting new patients
The Josselyn Center NFP CurrentSince Sep 4, 2024 Accepting new patients
Clear Therapy PLLC Current Accepting new patients
The Josselyn Center NFP Counselor Past Accepting new patients

Locations

2835 N Sheffield Ave
Ste 310
Chicago, IL 60657
Phone (773) 234-0695

1135 Skokie Blvd
Northbrook, IL 60062
Phone (224) 255-6075

405 Central Ave
Northfield, IL 60093
Phone (847) 441-5603

Organizations & group practices 4

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": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1801564513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 CENTRAL AVE",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933006",
            "telephone_number": "847-441-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 CENTRAL AVE",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933006",
            "telephone_number": "847-441-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOF",
        "first_name": "KRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.027676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, IL

Sources for this page

Verify at the official NPI Registry.