Samella Berry Abdullah, PH.D.
Individual provider Active NPI Clinical Social Worker · Chicago, IL
NPI 1356404263 · NPPES record last updated Apr 30, 2013
Key facts
- NPI
- 1356404263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 149 00 3743 (IL)
- Practice address
- 1525 E 53Rd St
#531
Chicago, IL 60615-4557 - Phone
- (888) 534-0369
- Fax
- (773) 752-3271
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW 6294 | FL | MD | Clinical Social Worker |
| 149 00 3743 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evans & Evans Counseling& Consulting Services Inc | Clinical | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW 6294 | FL | |
| Clinical Social Worker | 1041C0700X | 149 00 3743 | IL | Yes |
Addresses
Primary practice location
1525 E 53Rd St
#531
Chicago, IL 60615-4557
Mailing address
1525 E 53Rd St
#531
Chicago, IL 60615-4557
Phone (888) 534-0369
Other providers in Chicago, IL
- Ayesha Bakir Abdullah-Ewing
- Aamir Abdullah
- Larry R Abdullah
- Natalie Abdullah
- Rashidah Abdullah
- Zainab Abdullah
- Abdulmassih Abdulmassih
- Sarah Abdulmohsin
- Ritaj Abdulquani
- Noor Abdulrahman
All providers in Chicago, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.