Individual provider Active NPI

Middy Esther Fierro, MSW LICSW

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1487637641
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.014686 Issued in IL
Practice address
29 S Webster St Ste 290F
Naperville, IL 60540-5356
Phone
(630) 428-0057
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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 103058 MA
Clinical Social Worker 1041C0700X 149.014686 IL Primary

Addresses

Primary practice location

29 S Webster St Ste 290F
Naperville, IL 60540-5356

Mailing address

997 Belaire CT
Naperville, IL 60563-2401
Phone (630) 428-0057

Other practice location 1

225 W Jefferson Ave
Naperville, IL 60540-5312
Phone (630) 428-0057

Other identifiers 2

IdentifierTypeStateIssuer
084618000OtherMAMAGELLAN
P01325OtherMABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240320001833 CT Practitioner - Clinical Social Worker 9234393877 Practice locations: Simsbury, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18 Brettonwood Dr
Simsbury, CT 06070-1443
Phone (413) 374-8082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.014686ILMDClinical Social Worker
103058MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1487637641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 BELAIRE CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632401",
            "telephone_number": "630-428-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 S WEBSTER ST STE 290F",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405356",
            "telephone_number": "630-428-0057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 W Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605405312",
            "country_code": "US",
            "telephone_number": "630-428-0057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIERRO",
        "first_name": "MIDDY",
        "middle_name": "ESTHER",
        "name_prefix": "Mrs.",
        "credential": "MSW LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "103058",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "084618000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P01325",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.