Khalid Binwalid Scott, LCSW, CADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.017753 Issued in IL

Practice address

820 S Damen Ave
Hud-Vash 8 South
Chicago, IL 60612-3728

Phone

(312) 569-8281

Fax

(312) 569-8986

NPI assigned

Dec 23, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 2, 2024 through Jan 2, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Chicago'S High Achievers PC

  • Clinical Social Worker
  • Schaumburg, IL
  • NPI 1538326665
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1831554583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16926 MERRILL AVE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732675",
            "telephone_number": "312-437-2688",
            "fax_number": "312-569-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S DAMEN AVE",
            "address_2": "HUD-VASH 8 SOUTH",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123728",
            "telephone_number": "312-569-8281",
            "fax_number": "312-569-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "KHALID",
        "middle_name": "BINWALID",
        "name_prefix": "Mr.",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "149.017753",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CADC",
            "identifier": "30483",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Scott, PSY.D.
• Julie Rae Scott, LPC
• Karen A Scott, DDS
• Katherine Scott, LCPC, BC-DMT
• Kenyatta Scott, STA
• Kourtney Nikkole Scott
• Lashonda Scott, M.D,
• Latonya Deneen Scott
• Leodis F Scott Sr., M.A LPC ED.D
• Lonyia Scott

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.