Melissa Cauthen, LCSW
Individual provider Active NPI Clinical Social Worker · Carbondale, IL
NPI 1003586611 · NPPES record last updated Oct 30, 2024
Key facts
- NPI
- 1003586611
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 149023198 (IL)
- Practice address
- 1016 S Emerald LN
Carbondale, IL 62901-2434 - Phone
- (618) 559-6346
- NPI assigned
- Sep 15, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241119000408 | IL | Practitioner - Clinical Social Worker | 4486189107 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.023198 | IL | MD | Mental Health Counselor |
| 149023198 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Mental Health | Current |
Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Mental Health Counselor | 101YM0800X | 149.023198 | IL | |
| Clinical Social Worker | 1041C0700X | 149023198 | IL | Yes |
Addresses
Primary practice location
1016 S Emerald LN
Carbondale, IL 62901-2434
Mailing address
1016 S Emerald LN
Carbondale, IL 62901-2434
Phone (618) 559-6346
Other providers in Carbondale, IL
- Ken Castillo
- Catholic Social Services Carbondale
- Dianne Zuasula Catolos
- Mary Kay Cattaneo
- Meagan Elizabeth Causey
- Cedar Court Imaging LTD
- Center for Autism Spectrum Disorders
- Center for Comprehensive Services, Inc
- Center for Comprehensive Services, Inc.
- Centerstone of Illinois Inc
All providers in Carbondale, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.