Individual provider Active NPI

Andrea Nicole Good, MSW, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1003169830
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.017874 Issued in IL
Practice address
1806 N Damen Ave
Chicago, IL 60647-5511
Phone
(773) 270-0469
NPI assigned
Oct 17, 2012
Last updated
Aug 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Clinical Social Worker 1041C0700X 149.017874 IL Primary

Addresses

Primary practice location

1806 N Damen Ave
Chicago, IL 60647-5511

Mailing address

1806 N Damen Ave
Chicago, IL 60647-5511
Phone (773) 270-0469

Other practice location 1

2345 S Lynhurst Dr
Suite 205
Indianapolis, IN 46241-8630
Phone (317) 247-8900

Other practice location 2

2865 N Clybourn Ave
Chicago, IL 60618-8269
Phone (773) 270-0469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.017874ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ifc Premier, Professional Limited Liability Company CurrentSince Sep 21, 2025 Accepting new patients
Individual and Family Connection, LLC Counselor CurrentSince Jul 1, 2022 Accepting new patients

Locations

1806 N Damen Ave
Chicago, IL 60647
Phone (773) 270-0469

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1003169830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475511",
            "telephone_number": "773-270-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475511",
            "telephone_number": "773-270-0469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2345 S Lynhurst Dr",
            "address_2": "Suite 205",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462418630",
            "country_code": "US",
            "telephone_number": "317-247-8900",
            "fax_number": "317-247-8935",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2865 N Clybourn Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606188269",
            "country_code": "US",
            "telephone_number": "773-270-0469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOOD",
        "first_name": "ANDREA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.