Individual provider Active NPI

Paige Justine Fitterer, LCSW

  • Clinical Social Worker
  • Elmhurst, IL
National Provider Identifier
1174212419
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149025560 Issued in IL
Practice address
381 N York St Ste 20
Elmhurst, IL 60126-2300
Phone
(701) 290-7268
NPI assigned
May 3, 2023
Last updated
May 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149025560 IL Primary
School Social Worker 1041S0200X 1272973 IL

Addresses

Primary practice location

381 N York St Ste 20
Elmhurst, IL 60126-2300

Mailing address

542 W Crockett Ave
Elmhurst, IL 60126-1811
Phone (701) 290-7268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 23, 2024 through Jul 23, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149025560ILMDClinical Social Worker
1272973ILMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Home for Healing PLLC CurrentSince May 21, 2023 Accepting new patients

Locations

381 N York St
Ste 20
Elmhurst, IL 60126
Phone (701) 290-7268

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": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1174212419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 W CROCKETT AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261811",
            "telephone_number": "701-290-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 N YORK ST STE 20",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262300",
            "telephone_number": "701-290-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITTERER",
        "first_name": "PAIGE",
        "middle_name": "JUSTINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149025560",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IL",
            "license": "1272973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.