Erica Rae Fada

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

4411 N Ravenswood Ave Ste 250
Chicago, IL 60640-5802

Phone

(773) 892-1933

NPI assigned

Apr 30, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Head Heart Therapy Inc

  • Professional Counselor
  • Chicago, IL
  • NPI 1720407679
  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1651276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651276800000",
    "number": "1992440341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5007 N GLENWOOD AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606408429",
            "telephone_number": "636-328-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 N RAVENSWOOD AVE STE 250",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405802",
            "telephone_number": "773-892-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADA",
        "first_name": "ERICA",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-30",
        "last_updated": "2022-04-30",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olubukola (Buki) Adenike Fabusiwa, PHARM.D.
• Jourdan Facen, LPC
• Christopher Facer
• Imari Faceson, DO
• Facial Aesthetics Center of Excellence PC
• Anuoluwapo Grace Fadare
• William Thomas Fader
• Fadi a Habib MD Frcsc LTD
• Titilayo Fadiya
• Riskat Fadonougbo, PMHNP

• Addiction (Substance Use Disorder) Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Addiction (Substance Use Disorder) Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.