Mia Dagostino LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.017535 Issued in IL

Legal business name

MIA DAGOSTINO LLC

Practice address

60 Revere Dr
Suite 100
Northbrook, IL 60062-1563

Phone

(773) 266-8984

NPI assigned

Sep 30, 2015

Organization subpart

No

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

Authorized official

Name

Mia Teresa D'Agostino, LCSW

Title

Owner

Phone

(773) 266-8984

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1720458938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 W BARRY AVE",
            "address_2": "UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573105",
            "telephone_number": "773-266-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 REVERE DR",
            "address_2": "SUITE 100",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621563",
            "telephone_number": "773-266-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIA DAGOSTINO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "D'AGOSTINO",
        "authorized_official_first_name": "MIA",
        "authorized_official_middle_name": "TERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-266-8984",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avigail Merzel
• Deborah Kathryn Mestas, L.C.P.C.
• Jenna Metcalfe, RBT-19-103325
• Sarah Meyer, PT, DPT
• Pamela Meyerson, LCSW
• Michael a. Epstein MD SC
• Michael L. Stoller & Associates, LLC
• Midwest Express Care 2, Inc
• Jessica Mielenz, RBT-18-72105
• Melinda Mikes

• Clinical Social Worker in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; 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.