Andrew Weaver, LCSW, LTD.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149-009527 Issued in IL

Legal business name

ANDREW WEAVER, LCSW, LTD.

Practice address

4507 N Ravenswood Ave Ste 104
Chicago, IL 60640-5218

Phone

(773) 612-1342

Fax

(708) 525-0909

NPI assigned

Apr 9, 2009

Organization subpart

No

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

Authorized official

Name

Andrew Weaver, LCSWNPI 1851473672

Title

President

Phone

(773) 612-1342

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrew Weaver, L.C.S.W.

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1851473672
  Authorized official Same address or phone

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1063655801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4507 N RAVENSWOOD AVE STE 104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405218",
            "telephone_number": "773-612-1342",
            "fax_number": "708-525-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4507 N RAVENSWOOD AVE STE 104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405218",
            "telephone_number": "773-612-1342",
            "fax_number": "708-525-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW WEAVER, LCSW, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-09",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-612-1342",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-009527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "1636406",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelyn Andresen, PHARM.D., CGP
• Ryan Michael Andresen, PSY.D
• Andrew Agen Davis, MD SC
• Andrew B. Repasy M.D., S.C.
• Andrew Skolarz MD SC
• Andrew Willson
• Alex Devon Andrew, BT
• Brigid Catherine Andrew, CNM, RN
• Akhil Cyriac Andrews
• Allegra Andrews, 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 Aug 5, 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.