Organization Active NPI

Michelle Ferris, LCSW, PLLC

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1538931928
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MICHELLE FERRIS, LCSW, PLLC
Practice address
602 Michigan Ave Apt 1
Evanston, IL 60202-4661
Phone
(847) 859-9537
NPI assigned
Oct 27, 2023
Last updated
Oct 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Authorized official

Name
Michelle Ferris, LCSWNPI 1619222056
Title
Owner
Phone
(847) 859-9537

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

602 Michigan Ave Apt 1
Evanston, IL 60202-4661

Mailing address

602 Michigan Ave Apt 1
Evanston, IL 60202-4661
Phone (847) 859-9537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250904000903 IL Part B Supplier - Clinic/Group Practice 7416459045 Receives reassigned benefits from 2 practitioners
Practice locations: Evanston, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698364800000",
    "number": "1538931928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE APT 1",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602024661",
            "telephone_number": "847-859-9537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE APT 1",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602024661",
            "telephone_number": "847-859-9537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE FERRIS, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A",
        "authorized_official_last_name": "FERRIS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-859-9537",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.