Individual provider Active NPI

Carolyn Beth Gevirtz Stern, LCSW

  • Social Worker
  • Park Ridge, IL
National Provider Identifier
1922295088
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150010550 Issued in IL
Practice address
444 N Northwest Hwy Ste 320
Park Ridge, IL 60068-3277
Phone
(847) 220-7298
NPI assigned
Oct 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150010550 IL Primary

Addresses

Primary practice location

444 N Northwest Hwy Ste 320
Park Ridge, IL 60068-3277

Mailing address

928 N Delphia Ave
Park Ridge, IL 60068-2020
Phone (847) 840-0594

Other names 1

  • Carolyn Beth Gevirtz Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cstern@mainstcounselingsolutions.com Direct
Direct Messaging Address cstern@mainstcounselingsolutions.com Direct

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
150010550ILMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1922295088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 N DELPHIA AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682020",
            "telephone_number": "847-840-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N NORTHWEST HWY STE 320",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683277",
            "telephone_number": "847-220-7298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "CAROLYN",
        "middle_name": "BETH GEVIRTZ",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150010550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cstern@mainstcounselingsolutions.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "patient info",
            "address_1": "444 N Northwest Hwy Ste 320",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600683277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cstern@mainstcounselingsolutions.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "client info",
            "address_1": "444 N Northwest Hwy Ste 320",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600683277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "GEVIRTZ",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.