Individual provider Active NPI

Susan Lerner Melsky, MA LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1972588945
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149000570 Issued in IL
Practice address
3801 N Hamilton Ave # H
Chicago, IL 60618-4056
Phone
(847) 668-5254
NPI assigned
Dec 13, 2005
Last updated
Feb 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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 149000570 IL Primary

Addresses

Primary practice location

3801 N Hamilton Ave # H
Chicago, IL 60618-4056

Mailing address

3801 N Hamilton Ave
Chicago, IL 60618-4056
Phone (478) 668-5254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20051117000343 IL Practitioner - Clinical Social Worker 3476572512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2320 Central St
Apt 301
Evanston, IL 60201-1414
Phone (847) 668-5254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Organizations & group practices 1

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1972588945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 N HAMILTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184056",
            "telephone_number": "478-668-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 N HAMILTON AVE # H",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184056",
            "telephone_number": "847-668-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELSKY",
        "first_name": "SUSAN",
        "middle_name": "LERNER",
        "name_prefix": "Ms.",
        "credential": "MA LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149000570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.