Bernetta A Andrewin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.020822 Issued in IL

Practice address

4481 Ash Grove Dr Ste a-D
Springfield, IL 62711-6358

Phone

(217) 717-4733

Fax

(217) 679-5981

NPI assigned

Jun 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1033736707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 E KIMBLE ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627034626",
            "telephone_number": "773-993-4518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4481 ASH GROVE DR STE A-D",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116358",
            "telephone_number": "217-717-4733",
            "fax_number": "217-679-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWIN",
        "first_name": "BERNETTA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Anderson
• Rebecca D Anderson, PHD
• Sarah Anderson, OTA
• Todd W Anderson, MD
• Wallace M Anderson, MD
• Debra D Andrews, LCPC
• Jennifer Elizabeth Andrews, CRNA
• Angies Solutions LLC
• Olajide John Animasaun, PHARM.D
• Fadi Annaba, MD.

• Clinical Social Worker in Springfield, IL
• Providers in Springfield, 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 Jul 1, 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.