Individual provider Active NPI

Anastasiya Andreeva

  • Clinical Social Worker
  • Berwyn, IL
National Provider Identifier
1124542394
Registry record updated Aug 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
6918 W Windsor Ave
Berwyn, IL 60402-3334
Phone
(708) 995-3725
NPI assigned
Jul 31, 2017
Last updated
Aug 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

6918 W Windsor Ave
Berwyn, IL 60402-3334

Mailing address

5220 East Ave
Countryside, IL 60525-3133
Phone (087) 455-2777

Other practice location 1

5220 East Ave
Countryside, IL 60525-3133
Phone (708) 745-5277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Aug 18, 2025 through Aug 18, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Willow & Leaf PLLC Past Accepting new patients

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": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722729600000",
    "number": "1124542394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 EAST AVE",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605253133",
            "telephone_number": "087-455-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6918 W WINDSOR AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023334",
            "telephone_number": "708-995-3725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5220 East Ave",
            "address_purpose": "LOCATION",
            "city": "Countryside",
            "state": "IL",
            "postal_code": "605253133",
            "country_code": "US",
            "telephone_number": "708-745-5277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDREEVA",
        "first_name": "ANASTASIYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2024-08-04",
        "certification_date": "2024-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.