Individual provider Active NPI

Marjorie S Erdman, LCSW

  • Clinical Social Worker
  • Elgin, IL
National Provider Identifier
1346264694
Registry record updated Oct 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149010702 Issued in IL
Practice address
815 Logan Ave
Elgin, IL 60120-3010
Phone
(847) 531-8941
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2011

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 149010702 IL Primary

Addresses

Primary practice location

815 Logan Ave
Elgin, IL 60120-3010

Mailing address

815 Logan Ave
Elgin, IL 60120-3010
Phone (847) 531-8941

Other identifiers 1

IdentifierTypeStateIssuer
149010702OtherILLICENSE

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
149010702ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319241600000",
    "number": "1346264694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 LOGAN AVE",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601203010",
            "telephone_number": "847-531-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 LOGAN AVE",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601203010",
            "telephone_number": "847-531-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERDMAN",
        "first_name": "MARJORIE",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2011-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "149010702",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2011; 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.