Megan Gabrielle Bolotin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.018396 Issued in IL

Practice address

239 Appletree LN
Wilmette, IL 60091-3101

Phone

(847) 924-0775

NPI assigned

Oct 7, 2019

Last updated

Oct 7, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Covert Minds Therapy

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1386382505
  NPD Authorized official

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1841831286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 APPLETREE LN",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600913101",
            "telephone_number": "847-924-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 APPLETREE LN",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600913101",
            "telephone_number": "847-924-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLOTIN",
        "first_name": "MEGAN",
        "middle_name": "GABRIELLE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madelyn Bishop, LSW
• Martin Howard Blackman, PSY.D.
• Erika E. Blake, O.T.
• Katherine Bodkin, LPC
• Katherine Mary Boho, PSY.D.
• Scott M Bolton, M.D.
• Rachel Amanda Borowiec, MA, CCC-SLP
• Bri Ali LLC
• Terrie Bridgman
• Diane Brikha

• Clinical Social Worker in Wilmette, IL
• Providers in Wilmette, 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 Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.