Individual provider Active NPI

Veronica Tsu Lickfelt, LCSW

  • Clinical Social Worker
  • Oswego, IL
National Provider Identifier
1083925762
Registry record updated Jun 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149014218 Issued in IL
Practice address
25 E Jackson St FL 2
Oswego, IL 60543-8696
Phone
(773) 315-7045
Fax
(630) 551-2213
NPI assigned
Jun 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2010

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 149014218 IL Primary

Addresses

Primary practice location

25 E Jackson St FL 2
Oswego, IL 60543-8696

Mailing address

705 N Sparkle CT
Oswego, IL 60543-7942
Phone (773) 315-7045

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
I20110318000048 IL Practitioner - Clinical Social Worker 6901089655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Behavioral Health, P.C.Group PAC ID 7911904503, 2 clinicians

Practice addresses (Care Compare)

58 Chicago Rd
FL 2
Oswego, IL 60543-8611
Phone (630) 913-7045

705 N Sparkle Court
Oswego, IL 60543-7942

705 N Sparkle CT
Oswego, IL 60543-7942
Phone (630) 913-7045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Behavioral Health, P.C. Clinical CurrentSince Jan 1, 2011 Accepting new patients

Locations

525 S Washington St
Naperville, IL 60540
Phone (630) 637-9300

58 Chicago Rd
Fl 2
Oswego, IL 60543

58 Chicago Rd
#2
Oswego, IL 60543
Phone (630) 913-7045

Organizations & group practices 1

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": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277683200000",
    "number": "1083925762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 N SPARKLE CT",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437942",
            "telephone_number": "773-315-7045",
            "fax_number": "630-551-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E JACKSON ST FL 2",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605438696",
            "telephone_number": "773-315-7045",
            "fax_number": "630-551-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICKFELT",
        "first_name": "VERONICA",
        "middle_name": "TSU",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2010-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, IL

Sources for this page

Verify at the official NPI Registry.