Individual provider Active NPI

Mariah Jennifer Kuick, LCSW

  • Clinical Social Worker
  • Elgin, IL
National Provider Identifier
1023442456
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149021926 Issued in IL
Practice address
1845 Grandstand PL
Elgin, IL 60123-6603
Phone
(847) 695-0484
NPI assigned
Aug 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149021926 IL Primary

Addresses

Primary practice location

1845 Grandstand PL
Elgin, IL 60123-6603

Mailing address

1845 Grandstand PL
Elgin, IL 60123-6603
Phone (847) 695-0484

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
I20200211000445 IL Practitioner - Clinical Social Worker 8123454162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1845 Grandstand PL
Elgin, IL 60123-6603
Phone (847) 695-0484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149021926ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ecker Center for Behavioral Health CurrentSince Jan 6, 2020 Accepting new patients
Ecker Center for Behavioral Health Clinical Current Accepting new patients
Ecker Center for Behavioral Health CurrentSince Jan 6, 2020 Accepting new patients

Locations

1845 Grandstand Pl
Elgin, IL 60123

Organizations & group practices 3

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": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1023442456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 GRANDSTAND PL",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601236603",
            "telephone_number": "847-695-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 GRANDSTAND PL",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601236603",
            "telephone_number": "847-695-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUICK",
        "first_name": "MARIAH",
        "middle_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149021926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.