Individual provider Active NPI

Fernanda Morales-Veloz, LCSW

  • Adult Mental Health Clinic/Center
  • Chicago, IL
National Provider Identifier
1891380077
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Practice address
1811 W North Ave Ste 201
Chicago, IL 60622-1488
Phone
(773) 692-5050
NPI assigned
Mar 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Clinical Social Worker 1041C0700X 149026460 IL
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1811 W North Ave Ste 201
Chicago, IL 60622-1488

Mailing address

1811 W North Ave Ste 201
Chicago, IL 60622-1488
Phone (773) 692-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1891380077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 W NORTH AVE STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221488",
            "telephone_number": "773-692-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 W NORTH AVE STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221488",
            "telephone_number": "773-692-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES-VELOZ",
        "first_name": "FERNANDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-09",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149026460",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.