Individual provider Active NPI

Andrea L Rako, LCSW

  • Clinical Social Worker
  • Belleville, IL
National Provider Identifier
1407301245
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.006966 Issued in IL
Practice address
1500 Vicksburg Dr
Belleville, IL 62221-5806
Phone
(618) 977-0041
NPI assigned
Aug 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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 149.006966 IL Primary

Addresses

Primary practice location

1500 Vicksburg Dr
Belleville, IL 62221-5806

Mailing address

1500 Vicksburg Dr
Belleville, IL 62221-5806
Phone (618) 977-0041

Other names 1

  • Mrs. Andrea L Schickedanz Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160902001441 IL Practitioner - Clinical Social Worker 9638465446 Reassigns benefits to 1 organization
Practice locations: Belleville, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brave Health Medical Group, PAGroup PAC ID 9537586052, 93 clinicians

Practice addresses (Care Compare)

1500 Vicksburg Dr
Belleville, IL 62221-5806
Phone (305) 902-6347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.006966ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Health Medical Group PA CurrentSince Nov 1, 2023 Accepting new patients

Locations

1951 NW 7th Ave
Ste 300
Miami, FL 33136
Phone (305) 699-3101

Interoperability endpoints

  • Direct secure messaging: andrea.rako.1@23300.direct.athenahealth.com

Organizations & group practices 1

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": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1407301245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 VICKSBURG DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215806",
            "telephone_number": "618-977-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 VICKSBURG DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215806",
            "telephone_number": "618-977-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKO",
        "first_name": "ANDREA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.006966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "SCHICKEDANZ",
            "middle_name": "L",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.