Individual provider Active NPI

Stephanie Fariss, JD, LCSW

  • Psychoanalyst
  • Chicago, IL
National Provider Identifier
1154523454
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
IL149006322 Issued in IL
Practice address
25 E Washington St
Ste 1333
Chicago, IL 60602-1708
Phone
(312) 422-1281
Fax
(312) 422-9339
NPI assigned
May 31, 2007
Last updated
Aug 28, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X IL149006322 IL Primary

Addresses

Primary practice location

25 E Washington St
Ste 1333
Chicago, IL 60602-1708

Mailing address

25 E Washington St
Ste 1333
Chicago, IL 60602-1708
Phone (312) 422-1281

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
Credentials
Juris Doctor

State licenses

LicenseStateTypeSpecialty
IL149006322ILMDPsychoanalyst

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1154523454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST",
            "address_2": "STE 1333",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021708",
            "telephone_number": "312-422-1281",
            "fax_number": "312-422-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST",
            "address_2": "STE 1333",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021708",
            "telephone_number": "312-422-1281",
            "fax_number": "312-422-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARISS",
        "first_name": "STEPHANIE",
        "credential": "JD, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "IL",
            "license": "IL149006322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.