Individual provider Active NPI

Sandra I Ziesak-Serrano, LCSW

  • Clinical Social Worker
  • Barrington, IL
National Provider Identifier
1174259873
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012482 Issued in IL
Practice address
330 E Main St Ste 209
Barrington, IL 60010-3203
Phone
(224) 308-8534
NPI assigned
Jul 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.012482 IL Primary

Addresses

Primary practice location

330 E Main St Ste 209
Barrington, IL 60010-3203

Mailing address

880 Prague Ave
Buffalo Grove, IL 60089-2815
Phone (224) 308-8534

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
149.012482ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Take Good Care Counseling, Inc Clinical CurrentSince Aug 28, 2022 Accepting new patients

Locations

330 E Main St
Ste 209
Barrington, IL 60010
Phone (224) 308-8534

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": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1174259873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 PRAGUE AVE",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892815",
            "telephone_number": "224-308-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E MAIN ST STE 209",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600103203",
            "telephone_number": "224-308-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIESAK-SERRANO",
        "first_name": "SANDRA",
        "middle_name": "I",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barrington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.