Elizabeth Bierbaum Clarke, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

636 Church St Ste 418
Evanston, IL 60201-4580

Phone

(773) 484-7140

NPI assigned

Jul 16, 2007

Last updated

Feb 20, 2020By the provider in NPPES

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

Other names 1

• Elizabeth Bierbaum Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Third Wave Wellness, LLC

  • Clinical Social Worker
  • Evanston, IL
  • NPI 1205469277
  NPD Authorized official

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1417156738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST STE 418",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014580",
            "telephone_number": "773-484-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST STE 418",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014580",
            "telephone_number": "773-484-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "ELIZABETH",
        "middle_name": "BIERBAUM",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "BIERBAUM",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Bridget Kathrn Clancy
• Collin Clark
• Frank Milo Clark, M.D., PHD
• Ian Clark, MD
• Robert David Clark, PHD
• Emily Kastrul Clarke, L..C.S.W.
• Clarvoy Health
• Bishir Clayton, MD
• Emma Clear, D.O.
• Clearview Psychiatric Services LLC

• Clinical Social Worker in Evanston, IL
• Providers in Evanston, 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 Feb 20, 2020; 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.