Individual provider Active NPI

Clarissa Granados, MSW, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1821873704
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.027294 Issued in IL
Practice address
30 N Michigan Ave Ste 2029
Chicago, IL 60602-3611
Phone
(855) 264-9355
Fax
(855) 792-0240
NPI assigned
Aug 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.107913 IL
Clinical Social Worker 1041C0700X 149.027294 IL Primary

Addresses

Primary practice location

30 N Michigan Ave Ste 2029
Chicago, IL 60602-3611

Mailing address

30 N Michigan Ave Ste 2029
Chicago, IL 60602-3611
Phone (855) 264-9355

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
I20240718001709 IL Practitioner - Clinical Social Worker 2466998109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sherrie D All, PHD, PCGroup PAC ID 7618121922, 10 clinicians

Practice addresses (Care Compare)

30 N Michigan Ave
Suite 1621
Chicago, IL 60602-3669
Phone 85526493550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150.107913ILMDSocial Worker
149.027294ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sherrie D All, PHD, PC CurrentSince May 14, 2024 Accepting new patients

Locations

30 N Michigan Ave
Ste 1621
Chicago, IL 60602
Phone (773) 508-4788

30 N Michigan Ave
Ste 202
Chicago, IL 60602

30 N Michigan Ave
Ste 2029
Chicago, IL 60602
Phone (773) 345-3495

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": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1821873704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 2029",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023611",
            "telephone_number": "855-264-9355",
            "fax_number": "855-792-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 2029",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023611",
            "telephone_number": "855-264-9355",
            "fax_number": "855-792-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANADOS",
        "first_name": "CLARISSA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.107913",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.027294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.