Individual provider Active NPI

Angela Berra, LSW

  • School Social Worker
  • Swansea, IL
National Provider Identifier
1194540153
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
150103222 Issued in IL
Practice address
4933 Benchmark Centre Dr Ste E
Swansea, IL 62226-8927
Phone
(618) 929-4245
NPI assigned
Nov 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 150103222 IL Primary

Addresses

Primary practice location

4933 Benchmark Centre Dr Ste E
Swansea, IL 62226-8927

Mailing address

4933 Benchmark Centre Dr Ste E
Swansea, IL 62226-8927

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
150103222ILMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1194540153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4933 BENCHMARK CENTRE DR STE E",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622268927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4933 BENCHMARK CENTRE DR STE E",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622268927",
            "telephone_number": "618-929-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRA",
        "first_name": "ANGELA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IL",
            "license": "150103222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swansea, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.