Individual provider Active NPI

Erica C Ernst, LCSW, RDDP, CADC

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1285884635
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.014574 Issued in IL
Practice address
1740 Ridge Ave
301
Evanston, IL 60201-5918
Phone
(773) 425-1151
NPI assigned
Sep 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.014574 IL Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 28920 IL
Addiction (Substance Use Disorder) Counselor 101YA0400X 29747 IL
Paramedic 146L00000X 000519553 IL

Addresses

Primary practice location

1740 Ridge Ave
301
Evanston, IL 60201-5918

Mailing address

1740 Ridge Ave
301
Evanston, IL 60201-5918
Phone (773) 425-1151

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
28920ILMDAddiction (Substance Use Disorder) Counselor
29747ILMDAddiction (Substance Use Disorder) Counselor
149.014574ILMDClinical Social Worker
000519553ILMDParamedic

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1285884635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 RIDGE AVE",
            "address_2": "301",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602015918",
            "telephone_number": "773-425-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 RIDGE AVE",
            "address_2": "301",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602015918",
            "telephone_number": "773-425-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNST",
        "first_name": "ERICA",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "LCSW, RDDP, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014574",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "28920",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "29747",
            "primary": false
        },
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "IL",
            "license": "000519553",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.