Amy E Board, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.016736 Issued in IL

Practice address

700 N Sacramento Blvd
Suite 201
Chicago, IL 60612-1046

Phone

(773) 916-4084

NPI assigned

May 13, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amy E Fibich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Uplifted Therapy & Counseling PLLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1720865595
  NPD Authorized official
• Little City Foundation

  • Adolescent and Children Mental Health Clinic/Center
  • Chicago, IL
  • NPI 1730919523
  NPD (past) Authorized official
• Little City Foundation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1225364078
  NPD (past)

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1013395789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N SACRAMENTO BLVD",
            "address_2": "SUITE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121046",
            "telephone_number": "773-916-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N SACRAMENTO BLVD",
            "address_2": "SUITE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121046",
            "telephone_number": "773-916-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOARD",
        "first_name": "AMY",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-13",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "FIBICH",
            "middle_name": "E",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Board of Trustees of the University of Illinois
• Board of Trustees of the University of Illinois
• Board of Trustees of the University of Illinois
• Board of Trustees of the University of Illinois
• Board of Trustees of the University of Illinois
• Emma Marie Boat, MA
• Evelyn Boateng
• Kathryn E Boatwright, DPT
• Patricia Mary Boatwright, M.D.,
• Jessica Bobadilla, LCSW

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; 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.