MEDICARE: CAFE SOCIAL WORK CONSULTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1285458109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAFE SOCIAL WORK CONSULTING LLC

Provider Business Mailing Address
First Line	:	1019 W 110TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-3741
Country	:	US
Telephone Number	:	630-452-2301
Fax Number	:

Provider Business Practice Location Address
First Line	:	1019 W 110TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-3741
Country	:	US
Telephone Number	:	630-452-2301
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	ANJANETTE L YOUNG
Credential	:	LCSW
Telephone Number	:	630-452-2301

Provider Enumeration Date	:	11/08/2024
Last Update Date	:	02/04/2026

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