Individual provider Active NPI

Cynthia Everet Nichola Lincke, MSW, LCSW

  • Clinical Social Worker
  • Waukegan, IL
National Provider Identifier
1053934125
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.023956 Issued in IL
Practice address
33 N County St Ste 202
Waukegan, IL 60085-4315
Phone
(224) 639-3295
NPI assigned
May 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.103062 IL
Clinical Social Worker 1041C0700X 149.023956 IL Primary

Addresses

Primary practice location

33 N County St Ste 202
Waukegan, IL 60085-4315

Mailing address

33 N County St Ste 202
Waukegan, IL 60085-4315
Phone (224) 639-3295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
150.103062ILMDSocial Worker
149.023956ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inspired Elevations, PLLC Clinical CurrentSince Feb 1, 2022 Accepting new patients
Princesses and Ladies Inc. Current Accepting new patients

Locations

33 N County St
Ste 202B
Waukegan, IL 60085
Phone (847) 220-4427

Organizations & group practices 2

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": "1590278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1053934125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 N COUNTY ST STE 202",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854315",
            "telephone_number": "224-639-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 N COUNTY ST STE 202",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854315",
            "telephone_number": "224-639-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINCKE",
        "first_name": "CYNTHIA",
        "middle_name": "EVERET NICHOLA",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-24",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.103062",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.023956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.