Individual provider Active NPI

Brittany Merriweather, LCSW,CADC

  • Clinical Social Worker
  • South Holland, IL
National Provider Identifier
1467122143
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.022869 Issued in IL
Practice address
1214 E 158TH St
South Holland, IL 60473-1803
Phone
(312) 520-2148
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.022869 IL Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 31411 IL

Addresses

Primary practice location

1214 E 158TH St
South Holland, IL 60473-1803

Mailing address

1214 E 158TH St
South Holland, IL 60473-1803
Phone (773) 469-1297

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
31411ILMDAddiction (Substance Use Disorder) Counselor
149.022869ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1467122143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 E 158TH ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731803",
            "telephone_number": "773-469-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 E 158TH ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731803",
            "telephone_number": "312-520-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRIWEATHER",
        "first_name": "BRITTANY",
        "credential": "LCSW,CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.022869",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "31411",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.