Individual provider Active NPI

Rachel Selwyn, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1932472412
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.011789 Issued in IL
Practice address
2242 W Roscoe St Unit 1
Chicago, IL 60618-6390
Phone
(773) 472-2013
NPI assigned
Feb 15, 2012
Last updated
Feb 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.011789 IL Primary

Addresses

Primary practice location

2242 W Roscoe St Unit 1
Chicago, IL 60618-6390

Mailing address

2242 W Roscoe St Unit 1
Chicago, IL 60618-6390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190305000820 NJ Practitioner - Clinical Social Worker 7113186107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Supportive Care Psychology of NJ PCGroup PAC ID 6002162252, 23 clinicians

Practice addresses (Care Compare)

540 W Hanover Ave
Morris Township, NJ 07960-2500
Phone (718) 298-4375

Merit-based Incentive Payment System (MIPS)

Final score
96.24 of 100Reported as group
Quality
81.01
Improvement activities
40
Cost
88.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.011789ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care Psychology of NJ PC CurrentSince Feb 1, 2019 Accepting new patients
Home Psych Services, P.C. Past Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

560 Berkeley Ave
Orange, NJ 07050
Phone (973) 672-6500

540 W Hanover Ave
Township of Mendham, NJ 07960
Phone (973) 285-2800

1314 Brunswick Ave
Trenton, NJ 08638
Phone (609) 656-9291

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1932472412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2242 W ROSCOE ST UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2242 W ROSCOE ST UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186390",
            "telephone_number": "773-472-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELWYN",
        "first_name": "RACHEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.