Organization Active NPI

Melissa a. Frey, LCSW LLC

  • Clinical Social Worker
  • Northfield, IL
National Provider Identifier
1073986006
Registry record updated Nov 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149014856 Issued in IL
Legal business name
MELISSA A. FREY, LCSW LLC
Practice address
310 Happ Rd
Suite 201
Northfield, IL 60093-3455
Phone
(773) 644-1522
NPI assigned
Nov 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2015

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

Authorized official

Name
Melissa Ann EversonNPI 1598047797
Title
LCSW
Phone
(773) 644-1522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 149014856 IL Primary

Addresses

Primary practice location

310 Happ Rd
Suite 201
Northfield, IL 60093-3455

Mailing address

310 Happ Rd
Suite 201
Northfield, IL 60093-3455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151210000465 IL Part B Supplier - Clinic/Group Practice 6103127493 Receives reassigned benefits from 2 practitioners
Practice locations: Northfield, IL

National Provider Directory

National Provider Directory

Locations

540 W Frontage Rd
Ste 2115
Northfield, IL 60093
Phone (773) 644-1522

310 Happ Rd
Ste 201
Northfield, IL 60093
Phone (224) 306-9831

400 Central Ave
Ste 202
Northfield, IL 60093
Phone (773) 644-1522

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447372800000",
    "number": "1073986006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 HAPP RD",
            "address_2": "SUITE 201",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HAPP RD",
            "address_2": "SUITE 201",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933455",
            "telephone_number": "773-644-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA A. FREY, LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-13",
        "last_updated": "2015-11-13",
        "status": "A",
        "authorized_official_last_name": "EVERSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "773-644-1522"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.