Individual provider Active NPI

Carla Peltier, M.S.W., L.C.S.W.

  • Clinical Social Worker
  • Woodstock, IL
National Provider Identifier
1831447440
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149014997 Issued in IL
Practice address
101 South Jefferson Street
Woodstock, IL 60098
Phone
(815) 338-7360
Fax
(815) 337-5510
NPI assigned
Aug 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 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 149014997 IL Primary

Addresses

Primary practice location

101 South Jefferson Street
Woodstock, IL 60098

Mailing address

101 South Jefferson Street
Woodstock, IL 60098
Phone (815) 338-7360

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
I20160121001607 IL Practitioner - Clinical Social Worker 4789987967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Borst and Associates, IncGroup PAC ID 5597731604, 8 clinicians

Practice addresses (Care Compare)

901 Fox Glen CT
Barrington, IL 60010-1863
Phone (847) 304-0780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149014997ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Borst & Associates Inc Clinical CurrentSince Feb 11, 2016 Accepting new patients

Locations

901 Fox Gln
Barrington, IL 60010
Phone (847) 304-0770

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": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1831447440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SOUTH JEFFERSON STREET",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "60098",
            "telephone_number": "815-338-7360",
            "fax_number": "815-337-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SOUTH JEFFERSON STREET",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "60098",
            "telephone_number": "815-338-7360",
            "fax_number": "815-337-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTIER",
        "first_name": "CARLA",
        "credential": "M.S.W., L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

Verify at the official NPI Registry.