Active NPI
Stephanie Rene Gerberding, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1417554130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149018197
- Practice address
- 200 S Wacker Dr FL 31
Chicago, IL 60606-5877 - Phone
- (866) 849-0692
- NPI assigned
- Oct 6, 2020
- Last updated
- Nov 20, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149018197 | IL | Primary |
Addresses
Primary practice location
200 S Wacker Dr FL 31
Chicago, IL 60606-5877
Mailing address
2650 Ridge Ave.
Dept. of Psychiatry
Evanston, IL 60202-1011
Phone (847) 570-2540
Other practice location 1
1800 Greenleaf St
Evanston, IL 60202-1011
Phone (847) 409-2567
Other practice location 2
2650 Ridge Ave.
Dept. Of Psychiatry
Evanston, IL 60202-1011
Phone (847) 570-2540
Other names 1
- Stephanie Rene Berube
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149018197 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732060800000",
"number": "1417554130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 RIDGE AVE.",
"address_2": "DEPT. OF PSYCHIATRY",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602021011",
"telephone_number": "847-570-2540",
"fax_number": "847-570-2939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S WACKER DR FL 31",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606065877",
"telephone_number": "866-849-0692"
}
],
"practiceLocations": [
{
"address_1": "1800 Greenleaf St",
"address_purpose": "LOCATION",
"city": "Evanston",
"state": "IL",
"postal_code": "602021011",
"country_code": "US",
"telephone_number": "847-409-2567",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2650 Ridge Ave.",
"address_2": "Dept. Of Psychiatry",
"address_purpose": "LOCATION",
"city": "Evanston",
"state": "IL",
"postal_code": "602021011",
"country_code": "US",
"telephone_number": "847-570-2540",
"fax_number": "847-570-2939",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GERBERDING",
"first_name": "STEPHANIE",
"middle_name": "RENE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-06",
"last_updated": "2024-11-20",
"certification_date": "2024-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149018197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "STEPHANIE",
"last_name": "BERUBE",
"middle_name": "RENE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.