Individual provider Active NPI

Darren Dunahee, MBA, MSW, LCSW

  • Clinical Social Worker
  • Maryville, IL
National Provider Identifier
1053749432
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149014518 Issued in IL
Practice address
2921 Maryville Rd Ste B
Maryville, IL 62062-5400
Phone
(618) 484-9337
Fax
(618) 484-9353
NPI assigned
Oct 23, 2013
Last updated
Oct 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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 149014518 IL Primary

Addresses

Primary practice location

2921 Maryville Rd Ste B
Maryville, IL 62062-5400

Mailing address

1289 Cedar Creek LN
Centralia, IL 62801-9013
Phone (618) 315-2770

Other identifiers 1

IdentifierTypeStateIssuer
149.014518OtherILSTATE LICENSE NUMBER

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
I20131209000963 IL Practitioner - Clinical Social Worker 1052548591 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Southern Illinois University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Chair Counseling LLCGroup PAC ID 2163964594, 3 clinicians
Fortitude Trails CounselingGroup PAC ID 8921414947, 3 clinicians

Practice addresses (Care Compare)

2921 Maryville Rd
Suite B
Maryville, IL 62062-5400
Phone (618) 484-9337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
149014518ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Take It Easy Therapy PLLC Clinical CurrentSince Oct 20, 2024 Accepting new patients
Fortitude Trails Counseling Clinical CurrentSince Oct 14, 2024 Accepting new patients
Blue Chair Counseling LLC Clinical CurrentSince Oct 23, 2024 Accepting new patients

Locations

2921 Maryville Rd
#B
Maryville, IL 62062
Phone (618) 484-9337

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1053749432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1289 CEDAR CREEK LN",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628019013",
            "telephone_number": "618-315-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 MARYVILLE RD STE B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625400",
            "telephone_number": "618-484-9337",
            "fax_number": "618-484-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNAHEE",
        "first_name": "DARREN",
        "credential": "MBA, MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-23",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "149.014518",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.