Mia Teresa D'Agostino, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149-017535 Issued in IL

Practice address

2500 W Bradley PL Ste 210
Chicago, IL 60618-4716

Phone

(475) 215-1234

NPI assigned

Aug 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1669953683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 W BELLE PLAINE AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131857",
            "telephone_number": "773-266-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W BRADLEY PL STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184716",
            "telephone_number": "475-215-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 W Bradley Pl Ste 100",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606184716",
            "country_code": "US",
            "telephone_number": "475-215-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "D'AGOSTINO",
        "first_name": "MIA",
        "middle_name": "TERESA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-017535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• D Michael Kaye MD PC
• Glen D Souza, MD
• D. Gordon and Associates
• D.a. Jopp & Associates
• Ann M D'Addio, PT,MBA
• Mark D'Alesio, MD
• Traciann D'Almeida, M.D.
• Mitchell Robert D'Aloia, DO
• Peter Carl D'Aloia, D.D.S.
• Eileen Ryan D'Amico, MS, RD, LDN, CNSC

• All providers in Chicago, IL
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.