Individual provider Active NPI

Carrie Ann Estrada, LCSW

  • Clinical Social Worker
  • Streamwood, IL
National Provider Identifier
1376675215
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013330 Issued in IL
Practice address
1535 Burgundy Pkwy
Streamwood, IL 60107
Phone
(630) 518-6732
NPI assigned
Mar 9, 2007
Last updated
Nov 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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 149.013330 IL Primary

Addresses

Primary practice location

1535 Burgundy Pkwy
Streamwood, IL 60107

Mailing address

1535 Burgundy Pkwy
Streamwood, IL 60107-1811
Phone (630) 518-6732

Other practice location 1

920 E Broadway
Glendale, CA 91205-1204
Phone (818) 242-8403 ext. 245

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
149.013330ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1376675215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 BURGUNDY PKWY",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601071811",
            "telephone_number": "630-518-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 BURGUNDY PKWY",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "60107",
            "telephone_number": "630-518-6732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 E Broadway",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912051204",
            "country_code": "US",
            "telephone_number": "818-242-8403 x245",
            "fax_number": "818-242-3187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streamwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; 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.