Crimson Leadership Group

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149010344 Issued in IL

Legal business name

CRIMSON LEADERSHIP GROUP

Practice address

3339 Highland Ave
Berwyn, IL 60402-3817

Phone

(630) 248-9272

NPI assigned

Sep 15, 2014

Last updated

Sep 15, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Josette Heredia-Carmona, L.C.S.W

Title

President/Ceo

Phone

(630) 248-9272

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1912308453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3339 HIGHLAND AVE",
            "address_2": "APT/SUITE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023817",
            "telephone_number": "630-248-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3339 HIGHLAND AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023817",
            "telephone_number": "630-248-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRIMSON LEADERSHIP GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-15",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "HEREDIA-CARMONA",
        "authorized_official_first_name": "JOSETTE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "630-248-9272",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.C.S.W"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Berwyn, IL
• Providers in Berwyn, 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 Sep 15, 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.

Verify at the official NPI Registry.