Carolyn Sellers, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149018581 Issued in IL

Practice address

2539 N Kedzie Blvd Ste 4
Chicago, IL 60647-1435

Phone

(312) 620-0408

NPI assigned

Mar 29, 2017

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

Opted out of Medicare

Yes, effective Apr 11, 2025 through Apr 11, 2027

Medicare enrollment (NPD)

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.

• Humboldt Park Counseling, PLLC

  • Adult Mental Health Clinic/Center
  • Chicago, IL
  • NPI 1093606097
  NPD (past) Authorized official
• Humboldt Park Counseling, PLLC

  • Adult Mental Health Clinic/Center
  • Chicago, IL
  • NPI 1629787106
  NPD (past) Authorized official
• Humboldt Park Counseling, PLLC

  • Adult Mental Health Clinic/Center
  • Chicago, IL
  • NPI 1851094346
  NPD (past) Authorized official

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1871025940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 N KEDZIE BLVD STE 4",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471435",
            "telephone_number": "312-620-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 N KEDZIE BLVD STE 4",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471435",
            "telephone_number": "312-620-0408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3446 W Hirsch St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606512314",
            "country_code": "US",
            "telephone_number": "815-409-9805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "CAROLYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neil Robert Selinger, M.D.
• Debra Beth Selip, MD
• Adam James Selkirk, PSY.D.
• Isaiah Karim Joshua Selkridge
• Shelly Sella Sachs, LCSW
• Emily Sellers, M.D.
• Kevin Sellers, MD
• Ashley Kay Selley, M.D.
• Ryan Scott Selley, M.D.
• Kareem Selman-Jackson, MBBS

• 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 Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.