Amanda Creden Fairgrieve, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.018589 Issued in IL

Practice address

1611 W Harrison St Ste 106B
Chicago, IL 60612-4861

Phone

(312) 563-0830

NPI assigned

Jun 24, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  Medicare reassignment Care Compare group NPD
• Creden Psychotherapy and Consulting, PLLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1669341681
  NPD
• Rush University Medical Center

  dba Radiology Services

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1184269425
  NPD

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1346691946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 106B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-563-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 106B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-563-0830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 S Paulina St",
            "address_2": "Suite 438",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123808",
            "country_code": "US",
            "telephone_number": "800-757-0202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIRGRIEVE",
        "first_name": "AMANDA",
        "middle_name": "CREDEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Grace Fair, APRN
• Kyle Joseph Fairbanks, DMD
• Richard J Fairbrother, D.O.
• Carroll Fairchild
• Isabel F. Faircloth, APN,-CCNS , CNP
• Fairmont Care Centre, Inc.
• Fairview Care Center of Joliet, LLC
• Fairview Care Center of Lagrange, LLC
• Maya Noelle Faison, MD
• Faith Donohue, MSW, LCSW, PLLC

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.