Individual provider Active NPI

Alexandra Fliess

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1316395379
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149017811 Issued in IL
Practice address
2150 W Arthur Ave Apt 3
Chicago, IL 60645-5580
Phone
(773) 885-4147
NPI assigned
Jun 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 149017811 IL Primary

Addresses

Primary practice location

2150 W Arthur Ave Apt 3
Chicago, IL 60645-5580

Mailing address

1945 W Wilson Ave Ste 5115
Chicago, IL 60640-5258
Phone (773) 885-4147

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
149017811ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Center for Sexual Wellbeing Clinical Current Accepting new patients
Three Tales Therapy, LLC Clinical Current Accepting new patients

Locations

4809 N Ravenswood Ave
Ste 424
Chicago, IL 60640
Phone (773) 599-1609

1945 W Wilson Ave
Ste 5115
Chicago, IL 60640
Phone (312) 379-9350

Organizations & group practices 2

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": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1316395379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 W WILSON AVE STE 5115",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405258",
            "telephone_number": "773-885-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 W ARTHUR AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606455580",
            "telephone_number": "773-885-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLIESS",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149017811",
            "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 Oct 20, 2022; 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.