Individual provider Active NPI

Alyson Minkus, LCSW, CADC

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1629326483
Registry record updated Aug 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149017301 Issued in IL
Practice address
2530 Crawford Ave Ste 208
Evanston, IL 60201-4959
Phone
(847) 494-2472
NPI assigned
Aug 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2024

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 149017301 IL Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 30341 IL

Addresses

Primary practice location

2530 Crawford Ave Ste 208
Evanston, IL 60201-4959

Mailing address

256 Avon Ave
Northfield, IL 60093-3209
Phone (847) 494-2472

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
30341ILMDAddiction (Substance Use Disorder) Counselor
149017301ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1629326483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 AVON AVE",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933209",
            "telephone_number": "847-494-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE STE 208",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014959",
            "telephone_number": "847-494-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINKUS",
        "first_name": "ALYSON",
        "credential": "LCSW, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149017301",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "30341",
            "primary": false
        }
    ],
    "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 Aug 3, 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.

Verify at the official NPI Registry.