Individual provider Active NPI

Erin Anderson

  • Clinical Social Worker
  • Highland Park, IL
National Provider Identifier
1164763488
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.019418 Issued in IL
Practice address
2057 Green Bay Rd
Highland Park, IL 60035-6101
Phone
(224) 269-0243
NPI assigned
Mar 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150013331 IL
Developmental Therapist 222Q00000X
Clinical Social Worker 1041C0700X 149.019418 IL Primary

Addresses

Primary practice location

2057 Green Bay Rd
Highland Park, IL 60035-6101

Mailing address

1020 Bob O Link Rd
Highland Park, IL 60035-3607
Phone (224) 269-2043

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
150013331ILMDSocial Worker
149.019418ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Joyful Living Therapy and Wellness, PLLC Clinical CurrentSince May 25, 2021 Accepting new patients
Courage to Connect Therapeutic Center Past Accepting new patients

Locations

2057 Green Bay Rd
Ste A
Highland Park, IL 60035
Phone (224) 707-0572

2057 Green Bay Rd
Highland Park, IL 60035
Phone (224) 269-0243

Organizations & group practices 2

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": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1164763488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 BOB O LINK RD",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353607",
            "telephone_number": "224-269-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2057 GREEN BAY RD",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600356101",
            "telephone_number": "224-269-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ERIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150013331",
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.