Individual provider Active NPI

Leslie Banghart, L.C.S.W

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1821245036
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013093 Issued in IL
Practice address
3354 N Paulina St
206F
Chicago, IL 60657-1068
Phone
(312) 451-3053
NPI assigned
Aug 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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 149.013093 IL Primary

Addresses

Primary practice location

3354 N Paulina St
206F
Chicago, IL 60657-1068

Mailing address

5812 N Ridge Ave
Chicago, IL 60660-3446
Phone (312) 451-3053

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
I20241202001287 IL Practitioner - Clinical Social Worker 5395270250 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

53 W Jackson Blvd
Suite 925
Chicago, IL 60604-3845
Phone (312) 451-3053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.013093ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carol Connell LCSW PLLC Clinical PastSince Apr 17, 2019 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": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1821245036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5812 N RIDGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603446",
            "telephone_number": "312-451-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3354 N PAULINA ST",
            "address_2": "206F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571068",
            "telephone_number": "312-451-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGHART",
        "first_name": "LESLIE",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.