Individual provider Active NPI

Katie Kolzow, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1851776009
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.026943 Issued in IL
Practice address
3110 W Grand Ave
Chicago, IL 60622-4324
Phone
(773) 279-3736
NPI assigned
Jul 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 149.026943 IL Primary

Addresses

Primary practice location

3110 W Grand Ave
Chicago, IL 60622-4324

Mailing address

1449 N Artesian Ave Apt 1R
Chicago, IL 60622-1707
Phone (630) 217-7182

Other practice location 1

1845 Grandstand Pl
Elgin, IL 60123-6603
Phone (847) 695-0484 ext. 1875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.026943ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1851776009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 N ARTESIAN AVE APT 1R",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221707",
            "telephone_number": "630-217-7182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 W GRAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224324",
            "telephone_number": "773-279-3736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1845 Grandstand Pl",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601236603",
            "country_code": "US",
            "telephone_number": "847-695-0484 x1875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLZOW",
        "first_name": "KATIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-29",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026943",
            "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 Apr 2, 2024; 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.