Active NPI
Stephanie Indianer, LCSW, MAT
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1770130171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 2409 N Clybourn Ave
Chicago, IL 60614-6185 - Phone
- (773) 755-1775
- NPI assigned
- Aug 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
2409 N Clybourn Ave
Chicago, IL 60614-6185
Mailing address
2231 N Sawyer Ave Apt a
Chicago, IL 60647-1089
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566259200000",
"number": "1770130171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2231 N SAWYER AVE APT A",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606471089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2409 N CLYBOURN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606146185",
"telephone_number": "773-755-1775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INDIANER",
"first_name": "STEPHANIE",
"credential": "LCSW, MAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-20",
"last_updated": "2019-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
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- Individualized Aging Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.