Individual provider Active NPI

Adriana Izquierdo, LMSW

  • Social Worker
  • Chattanooga, TN
National Provider Identifier
1124772348
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
13344 Issued in TN
Practice address
1201 S Seminole Dr
Chattanooga, TN 37412-1135
Phone
(423) 486-0774
NPI assigned
Feb 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 13344 TN Primary

Addresses

Primary practice location

1201 S Seminole Dr
Chattanooga, TN 37412-1135

Mailing address

1101 W 40TH St Unit 2225
Chattanooga, TN 37409-1379
Phone (423) 486-0774

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aizquierdo@eluccc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13344TNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Elu LLC CurrentSince Feb 13, 2022 Accepting new patients

Locations

1101 W 40th St
Unit 2225
Chattanooga, TN 37409
Phone (423) 486-0774

1201 S Seminole Dr
Chattanooga, TN 37412
Phone (423) 486-0774

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1124772348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 W 40TH ST UNIT 2225",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374091379",
            "telephone_number": "423-486-0774",
            "fax_number": "423-405-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S SEMINOLE DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374121135",
            "telephone_number": "423-486-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZQUIERDO",
        "first_name": "ADRIANA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "13344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aizquierdo@eluccc.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1201 S Seminole Dr",
            "city": "Chattanooga",
            "state": "TN",
            "country_code": "US",
            "postal_code": "374121135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; 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.