Individual provider Active NPI

Amber Berridge, LCSW

  • Clinical Social Worker
  • Westmont, IL
National Provider Identifier
1972065878
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.023668
Practice address
414 Plaza Dr Ste 301
Westmont, IL 60559-5508
Phone
(630) 728-1744
NPI assigned
Apr 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 149.023668 Primary

Addresses

Primary practice location

414 Plaza Dr Ste 301
Westmont, IL 60559-5508

Mailing address

735 N Lindberg St
Griffith, IN 46319-2033
Phone (219) 682-5892

Other practice location 1

6415 Stanley Ave
Berwyn, IL 60402-3130
Phone (708) 995-3676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920001917 IL Practitioner - Clinical Social Worker 5193179497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nexumhc Consultants, PLLCGroup PAC ID 5698134005, 13 clinicians

Practice addresses (Care Compare)

7373 N Lincoln Ave
Lincolnwood, IL 60712-1704
Phone (773) 945-1994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nexumhc Consultants, PLLC Clinical CurrentSince Jul 2, 2023 Accepting new patients

Locations

7373 N Lincoln Ave
Ste 400
Lincolnwood, IL 60712
Phone (219) 805-3593

7373 N Lincoln Ave
Lincolnwood, IL 60712
Phone (773) 887-6150

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1972065878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 N LINDBERG ST",
            "city": "GRIFFITH",
            "state": "IN",
            "postal_code": "463192033",
            "telephone_number": "219-682-5892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 PLAZA DR STE 301",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595508",
            "telephone_number": "630-728-1744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6415 Stanley Ave",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604023130",
            "country_code": "US",
            "telephone_number": "708-995-3676",
            "fax_number": "708-788-8535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRIDGE",
        "first_name": "AMBER",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "149.023668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

Verify at the official NPI Registry.