7739956300 NPI 1336685494

NPI Information

  • NPI: 1336685494
  • Provider Name: 7739956300
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Former Legal Business Name: TCA HEALTH CARE
  • CLIA Number: 14D0425869
  • Address: 1029 E 130TH ST
    CHICAGO, IL
    ZIP 60628
  • Phone: (773) 995-6300

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NPI Details

7739956300 is a clinical social worker in Chicago, IL. The provider is 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. 7739956300 NPI is 1336685494. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Tca Health Care.

The provider's business location address is:

1029 E 130TH ST
CHICAGO, IL
ZIP 60628-908
Phone: (773) 995-6300
Fax: (773) 995-6192

The provider's authorized official is Marquetta D Hall .
The authorized official title is Billing Coding Specialist and has the following contact phone number (773) 995-6300.

The CLIA number assigned to this NPI record is 14D0425869 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/13/2017 and was last updated on 1/13/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinical149018713ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1149018713OTHERILLINOIS149018713

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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