MR. JEROME PIETRUSIAK (NPI# 1679793913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679793913 |
| Entity Type | Individual |
| Full Name | MR. JEROME PIETRUSIAK |
| Credential | LICENSED CLINICAL SO |
| Practice Address |
3456 W Franklin Blvd Chicago IL 60624-1308 |
| Mailing Address |
2105 Sunnyside Westchester IL 60154-5205 |
| Practice Telephone | 7735336013 |
| Mailing Telephone | 7085629070 |
| Mailing Fax Number | 7085629073 |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2019-12-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | 149002241 | IL | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149.002241 | IL | Behavioral Health & Social Service Providers |
| Street Address |
3456 W FRANKLIN BLVD |
| City | CHICAGO |
| State | IL |
| Zip Code | 60624-1308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760630750 | Pcc Community Wellness Center | Clinic/Center | 3456 W Franklin Blvd, Chicago, IL 60624-1308 | 2008-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071932 | Euginia Ivanova | Counselor | 3410 W. Roosevelt Rd, Chicago, IL 60624 | 2020-10-19 |
| 1629619572 | Denise R Bean | Technician | 3322 West Polk St, Chicago, IL 60624 | 2019-10-02 |
| 1033693742 | Ahmed Hussain Memon | Nurse Practitioner | 3800 West Madison, Chicago, IL 60624 | 2018-09-18 |
| 1487104006 | Jeffrey Blythe | Social Worker | 3605 W. Fillmore Street, Ucan, Chicago, IL 60624 | 2016-10-06 |
| 1366992216 | Brian Macwilliams | Social Worker | 3605 W. Fillmore St, Chicago, IL 60624 | 2016-10-04 |
| 1982151510 | Darryl Lamont Clayton | Counselor | 3605 W. Fillmore, Chicago, IL 60624 | 2016-09-01 |
| 1821487646 | Total Enrichment Services Inc. | Counselor | 3335 W Washington Blvd, Chicago, IL 60624 | 2015-01-16 |
| 1295038818 | Raad N Rashan M D S C | Internal Medicine | 3743 W Chicago Ave, Chicago, IL 60624 | 2010-12-21 |
| 1194044453 | Theresa Roberts | Speech-Language Pathologist | 3240 W. Franklin Blvd, Chicago, IL 60624 | 2010-05-26 |
| 1154570208 | Ht Outpatient Pharmacy | Pharmacy | 3435 W Vanburen St, Chicago, IL 60624 | 2008-09-13 |
| Find all providers in zip 60624 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| Find all providers in CHICAGO | ||||
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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.