MR. TARIK MARWAN QAZZAZ (NPI# 1598014797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598014797 |
| Entity Type | Individual |
| Full Name | MR. TARIK MARWAN QAZZAZ |
| Credential | LCSW |
| Practice Address |
4740 N Clark St Chicago IL 60640-4689 |
| Practice Telephone | 7737690205 |
| Practice Fax Number | 7737650801 |
| Mailing Telephone | 7737690205 |
| Mailing Fax Number | 7737650801 |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2012-09-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149.015178 | IL | Behavioral Health & Social Service Providers |
| Street Address |
4740 N CLARK ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640-4689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861411357 | Todd Frederick Harrison | Social Worker | 4740 N Clark St, C/o C4, Chicago, IL 60640-4689 | 2006-07-18 |
| 1972141950 | Alison Dowd | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2019-12-20 |
| 1275007486 | Teri Cicurel | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2019-01-22 |
| 1609346410 | Chantal Pico | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2018-12-05 |
| 1023595683 | Michelle L Johnson | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2018-07-25 |
| 1649770827 | Judith D Russell | Registered Nurse | 4740 N Clark St, Chicago, IL 60640-4689 | 2018-02-14 |
| 1871009167 | Andrea Vernon-cwik | Social Worker | 4740 N Clark St, Chicago, IL 60640-4689 | 2017-12-21 |
| 1790290385 | Anna Lyman | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2017-12-05 |
| 1639540974 | John Vizuete | Social Worker | 4740 N Clark St, Chicago, IL 60640-4689 | 2015-10-13 |
| 1063888618 | Monica Sade Mitchell | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2015-08-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
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| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
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|---|---|---|---|---|
| 1295336022 | Web Healing Collective Pllc | Social Worker | 6207 N Springfield Ave, Chicago, IL 60659-1015 | 2020-11-06 |
| 1881295186 | Belva Marie Dibert | Social Worker | 6330 S Ingleside Ave Apt 3, Chicago, IL 60637-5784 | 2020-11-03 |
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1164022422 | Brittany Lauren Gatchell | Social Worker | 7448 N Damen Ave Apt 3n, Chicago, IL 60645-2258 | 2020-10-27 |
| 1467052803 | Seri Elaine Porter | Social Worker | 4258 N Greenview Ave Apt 2d, Chicago, IL 60613-1173 | 2020-10-26 |
| 1255930707 | Emily Ehrens | Social Worker | 303 W Institute Pl Ste 300, Chicago, IL 60610-3080 | 2020-10-25 |
| 1316546955 | Yesenia Maldonado | Social Worker | 3922 N Sayre Ave, Chicago, IL 60634-2329 | 2020-10-24 |
| 1144829201 | Andrea Hohf, Mscd, Lcsw | Social Worker | 564 W Randolph St Ste 248, Chicago, IL 60661-2218 | 2020-10-20 |
| 1215536693 | Miracleworks Therapy & Consulting LLC | Social Worker | 2138 S Indiana Ave, Chicago, IL 60616-4930 | 2020-10-18 |
| 1104425552 | Fifth Star Collective, LLC | Social Worker | 2711 N Lawndale Ave Unit 2, Chicago, IL 60647-1127 | 2020-10-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.