Ann Lucia Chan, LCPC, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.012797 Issued in IL

Practice address

206 N Randolph St Ste 401
Champaign, IL 61820-8812

Phone

(217) 390-2917

Fax

(217) 355-1866

NPI assigned

Dec 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1851451272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 S ANDERSON ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618016711",
            "telephone_number": "217-390-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N RANDOLPH ST STE 401",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618208812",
            "telephone_number": "217-390-2917",
            "fax_number": "217-355-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ANN",
        "middle_name": "LUCIA",
        "name_prefix": "Miss",
        "credential": "LCPC, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.004709",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.006166",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IL",
            "license": "1465346",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Champaign Urbana Public Health Department
• Champaign Urbana Public Health Department
• Champaign Urbana Public Health District
• Champaign Urbana Public Health District
• Champaign-Urbana Healthcare LLC
• Carly Chandler
• Jennifer L Chandler
• Kessie Chandler, PA
• Jie Si Chang
• Barry Chapman

• Clinical Social Worker in Champaign, IL
• Providers in Champaign, 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 Feb 18, 2021; 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.