Individual provider Active NPI

Maggie Earanky, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1093064701
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149022184 Issued in IL
Practice address
4318 S State St
Chicago, IL 60609-3701
Phone
(773) 285-9304
Fax
(773) 564-3501
NPI assigned
Sep 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149022184 IL Primary
Social Worker 104100000X 6801094640 MI

Addresses

Primary practice location

4318 S State St
Chicago, IL 60609-3701

Mailing address

500 NE Multnomah St Ste 100
Portland, OR 97232-2099
Phone (503) 813-2000

Other practice location 1

511 Griffin Rd
West Branch, MI 48661-9251
Phone (989) 345-5571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230203002500 OR Practitioner - Clinical Social Worker 9335567981 Reassigns benefits to 1 organization
I20241003003443 WA Practitioner - Clinical Social Worker 9335567981 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801094640MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 18, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Social Worker Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Social Worker CurrentSince Jul 25, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 18, 2022 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

500 NE Multnomah St
Fl 11
Portland, OR 97232

500 NE Multnomah St
Ste 100
Portland, OR 97232
Phone (503) 499-5200

19500 SE Stark St
Portland, OR 97233
Phone (503) 669-3900

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 4

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": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1093064701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322099",
            "telephone_number": "503-813-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 S STATE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606093701",
            "telephone_number": "773-285-9304",
            "fax_number": "773-564-3501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 Griffin Rd",
            "address_purpose": "LOCATION",
            "city": "West Branch",
            "state": "MI",
            "postal_code": "486619251",
            "country_code": "US",
            "telephone_number": "989-345-5571",
            "fax_number": "989-345-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EARANKY",
        "first_name": "MAGGIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149022184",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801094640",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.