Fifth Star Collective, LLC
Social Worker (Clinical)

Address: 2711 N Lawndale Ave Unit 2, Chicago, IL 60647-1127
Phone: 7209829038

Fifth Star Collective, LLC (NPI# 1104425552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1104425552
Entity Type Organization
Organization Name FIFTH STAR COLLECTIVE, LLC
Practice Address 2711 N Lawndale Ave Unit 2
Chicago
IL 60647-1127
Practice Telephone 7209829038
Mailing Address 3914 W Altgeld St # 2e
Chicago
IL 60647-1004
Authorized Official Name Mr. Connor Williams (CO-FOUNDER, SENIOR CONSULTANT)
Authorized Official Telephone 7209829038
Organization Subpart No, this organization is not a Subpart
Enumeration Date 2020-10-17
Last Update Date 2020-10-17

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 1041C0700X Social Worker · Clinical Behavioral Health & Social Service Providers

Other Provider Identifier

State Identifier Issuer Type Code
IL 149.018440 OTHER LICENSED CLINICAL SOCIAL WORKER
1336597418 OTHER PERSONAL NPI

Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

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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Office Location

Street Address 2711 N LAWNDALE AVE UNIT 2
City CHICAGO
State IL
Zip Code 60647-1127

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1942704580 Team Rehabilitation Il15, LLC Physical Therapist 1923 N Western Avenue, Chicago, IL 60647 2018-03-20
1023517331 Chicago Medical Healthcare Group, S.c. Family Medicine 3648 W Armitage Avenue, Chicago, IL 60647 2018-02-02
1023537693 Erin Frommeyer Physician Assistant 2228 W Dickens Avenue, Chicago, IL 60647 2017-09-15
1457872475 Stefanie Paola Maurtua Behavior Analyst 2448 West Bloomingdale Ave., Apt 2e, Chicago, IL 60647 2017-06-29
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Competitor

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City CHICAGO
Zip Code 60647

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Dataset Information

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.