Individual provider Active NPI

Melissa A Everson, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1598047797
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149014856 Issued in IL
Practice address
625 N Michigan Ave
Suite 1750
Chicago, IL 60611-3110
Phone
(312) 970-0123
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149014856 IL Primary

Addresses

Primary practice location

625 N Michigan Ave
Suite 1750
Chicago, IL 60611-3110

Mailing address

625 N Michigan Ave
Suite 1750
Chicago, IL 60611-3110
Phone (733) 644-1522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20151210000591 IL Practitioner - Clinical Social Worker 1557662855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Melissa a Frey LCSW LLCGroup PAC ID 6103127493, 2 clinicians

Practice addresses (Care Compare)

400 Central Ave
Suite 202
Northfield, IL 60093-3024
Phone (773) 644-1522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149014856ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Melissa a. Frey, LCSW LLC Clinical CurrentSince Nov 13, 2015 Accepting new patients
Rachel Dubrow LCSW PLLC Clinical PastSince Nov 13, 2015 Accepting new patients
Neera Mehta, PH.D., P.C. Past Accepting new patients

Locations

400 Central Ave
Ste 202
Northfield, IL 60093
Phone (773) 644-1522

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1598047797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N MICHIGAN AVE",
            "address_2": "SUITE 1750",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113110",
            "telephone_number": "733-644-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N MICHIGAN AVE",
            "address_2": "SUITE 1750",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113110",
            "telephone_number": "312-970-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERSON",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.