Individual provider Active NPI

Melissa R Berler, LCSW

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1215045331
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149006471 Issued in IL
Practice address
1633 Asbury Ave
Evanston, IL 60201-4101
Phone
(847) 533-7686
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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 149006471 IL Primary

Addresses

Primary practice location

1633 Asbury Ave
Evanston, IL 60201-4101

Mailing address

1633 Asbury Ave
Evanston, IL 60201-4101
Phone (847) 533-7686

Other identifiers 1

IdentifierTypeStateIssuer
01622905OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031217000612 IL Practitioner - Clinical Social Worker 0547167504 Practice locations: Evanston, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1633 Asbury Ave
Evanston, IL 60201-4101
Phone (847) 533-7686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149006471ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service of Lake County PastSince Aug 28, 2022 Accepting new patients

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1215045331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 ASBURY AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014101",
            "telephone_number": "847-533-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 ASBURY AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014101",
            "telephone_number": "847-533-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLER",
        "first_name": "MELISSA",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149006471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01622905",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.