Individual provider Active NPI

Anne Carter, LCSW, CADC

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1053703603
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149019242 Issued in IL
Practice address
30 N Michigan Ave Ste 424
Chicago, IL 60602-3844
Phone
(312) 279-9981
Fax
(312) 279-9981
NPI assigned
Feb 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 31655 IL
Clinical Social Worker 1041C0700X 149019242 IL Primary

Addresses

Primary practice location

30 N Michigan Ave Ste 424
Chicago, IL 60602-3844

Mailing address

30 N Michigan Ave Ste 424
Chicago, IL 60602-3844
Phone (312) 279-9981

Other identifiers 2

IdentifierTypeStateIssuer
31655OtherILCADC
149019242OtherILLCSW

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MINDBODYCOOP.ANNECARTER@147350.ADVANCEDMD-DIRECT.COM Health Information Exchange (HIE) Mind Body Co-op

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
31655ILMDAddiction (Substance Use Disorder) Counselor
149019242ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Body Co-Op Addiction (Substance Use Disorder) CurrentSince Dec 12, 2021 Accepting new patients
Mind Body Co-Op Clinical CurrentSince Oct 1, 2022 Accepting new patients

Locations

30 N Michigan Ave
Ste 424
Chicago, IL 60602
Phone (312) 279-9981

3209 N Lakewood Ave
Chicago, IL 60657
Phone (312) 279-9981

Interoperability endpoints

  • Direct secure messaging: mindbodycoop.annecarter@147350.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1053703603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 424",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023844",
            "telephone_number": "312-279-9981",
            "fax_number": "312-279-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 424",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023844",
            "telephone_number": "312-279-9981",
            "fax_number": "312-279-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "ANNE",
        "credential": "LCSW, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-19",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "31655",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CADC",
            "identifier": "31655",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "149019242",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MINDBODYCOOP.ANNECARTER@147350.ADVANCEDMD-DIRECT.COM",
            "affiliation": "Y",
            "endpointDescription": "amd",
            "affiliationName": "Mind Body Co-op",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "30 N Michigan Ave Ste 424",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606023844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 13, 2022; 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.