Bertha Davis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149024731 Issued in IL

Practice address

1010 Lake St
Oak Park, IL 60301-1147

Phone

(708) 970-7512

NPI assigned

Sep 5, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Finding Balance Counseling and Therapy Services LLC

  • Clinical Social Worker
  • Oak Park, IL
  • NPI 1821660457
  NPD (past)

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1154042679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4926 W RICE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606513151",
            "telephone_number": "773-494-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011147",
            "telephone_number": "708-970-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BERTHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149024731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.findingbalancetherapyandcounselingservicesllc.com/",
            "affiliation": "Y",
            "affiliationName": "Finding Balance Counseling and Therapy services",
            "address_1": "1010 Lake St",
            "city": "Oak Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "603011147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Datta Sambare MD SC
• Davenport Medical Inc
• David R Schatz MD SC
• Robert Emmett Davies III, LCSW
• Davis Chiropractic, LTD
• Charles Edward Davis, PH.D.
• Chirah Alvinay Davis
• Daryl Ellis Davis, DC
• Georgetta J Davis
• Julene Davis, PMHNP

• Clinical Social Worker in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.