Individual provider Active NPI

Elizabeth A Brice, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1205322500
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.020163 Issued in IL
Practice address
4410 N Ravenswood Ave Ste 101
Chicago, IL 60640-5873
Phone
(773) 244-6401
NPI assigned
Jul 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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 149.020163 IL Primary

Addresses

Primary practice location

4410 N Ravenswood Ave Ste 101
Chicago, IL 60640-5873

Mailing address

3201 W Leland Ave Apt 211
Chicago, IL 60625-8360
Phone (708) 567-9726

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
149.020163ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1205322500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 W LELAND AVE APT 211",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606258360",
            "telephone_number": "708-567-9726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 N RAVENSWOOD AVE STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405873",
            "telephone_number": "773-244-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICE",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020163",
            "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 Jul 10, 2018; 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.