Individual provider Active NPI

Amy Houghton Bash, LCSW

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1114196730
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149003856 Issued in IL
Practice address
735 Chicago Ave Unit 348
Evanston, IL 60202-2378
Phone
(847) 542-5687
NPI assigned
Feb 28, 2008
Last updated
Aug 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 149003856 IL
Clinical Social Worker 1041C0700X 149003856 IL Primary

Addresses

Primary practice location

735 Chicago Ave Unit 348
Evanston, IL 60202-2378

Mailing address

735 Chicago Ave Unit 348
Evanston, IL 60202-2378
Phone (847) 542-5687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Sep 11, 2024 through Sep 11, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1114196730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 CHICAGO AVE UNIT 348",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022378",
            "telephone_number": "847-542-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 CHICAGO AVE UNIT 348",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022378",
            "telephone_number": "847-542-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASH",
        "first_name": "AMY",
        "middle_name": "HOUGHTON",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149003856",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149003856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.