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NPI Code Detail

MEDICARE: ALEXIS ANYA GOLDEN LSW

MEDICARE: ALEXIS ANYA GOLDEN LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker149041108IL

General Provider Information

NPI Number : 1043865132
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS ANYA GOLDEN LSW
Provider Business Mailing Address
First Line : 9444 LOWELL AVE
Second Line :
City : SKOKIE
State : IL
Zip : 60076-1455
Country : US
Telephone Number : 847-293-3296
Fax Number :
Provider Business Practice Location Address
First Line : 150 S WACKER DR STE 2400
Second Line :
City : CHICAGO
State : IL
Zip : 60606-4211
Country : US
Telephone Number : 847-293-3296
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2019
Last Update Date : 06/03/2026

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