Active NPI
Tiffany Cheryl Gholson, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1902294861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.014440
- Practice address
- 365 N Jefferson St
Suite 2207
Chicago, IL 60661-1226 - Phone
- (217) 202-8433
- NPI assigned
- Dec 30, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.014440 | IL | Primary |
Addresses
Primary practice location
365 N Jefferson St
Suite 2207
Chicago, IL 60661-1226
Mailing address
365 N Jefferson St
Suite 2207
Chicago, IL 60661-1226
Phone (217) 202-8433
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.014440 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419897600000",
"number": "1902294861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "365 N JEFFERSON ST",
"address_2": "SUITE 2207",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606611226",
"telephone_number": "217-202-8433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 N JEFFERSON ST",
"address_2": "SUITE 2207",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606611226",
"telephone_number": "217-202-8433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHOLSON",
"first_name": "TIFFANY",
"middle_name": "CHERYL",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-30",
"last_updated": "2014-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.014440",
"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 Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.