Organization Active NPI

Constellation Collective

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1841920915
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CONSTELLATION COLLECTIVE
Practice address
6666 N Western Ave
Chicago, IL 60645-5106
Phone
(312) 857-6716
NPI assigned
Jun 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Authorized official

Name
Jessica Levine, LCSWNPI 1578009536
Title
Staff Therapist
Phone
(224) 215-6524

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

6666 N Western Ave
Chicago, IL 60645-5106

Mailing address

1401 W Elmdale Ave Unit 3
Chicago, IL 60660-2588

National Provider Directory

National Provider Directory

Locations

6666 N Western Ave
Chicago, IL 60645
Phone (224) 215-6524

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1841920915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W ELMDALE AVE UNIT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606602588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6666 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606455106",
            "telephone_number": "312-857-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSTELLATION COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "STAFF THERAPIST",
        "authorized_official_telephone_number": "224-215-6524",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.