Individual provider Active NPI

Berklee Kruce, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1245827245
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015107 Issued in IL
Practice address
201 E Huron St Ste 11-140
Chicago, IL 60611-2968
Phone
(312) 926-3455
Fax
(312) 695-1903
NPI assigned
Dec 23, 2020
Last updated
Feb 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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 149015107 IL Primary

Addresses

Primary practice location

201 E Huron St Ste 11-140
Chicago, IL 60611-2968

Mailing address

201 E Huron St Ste 11-140
Chicago, IL 60611-2968
Phone (312) 926-3455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1245827245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E HURON ST STE 11-140",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112968",
            "telephone_number": "312-926-3455",
            "fax_number": "312-695-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E HURON ST STE 11-140",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112968",
            "telephone_number": "312-926-3455",
            "fax_number": "312-695-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUCE",
        "first_name": "BERKLEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-23",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.