Individual provider Active NPI

Linda Sheehan, LCSW

  • Clinical Social Worker
  • Grayslake, IL
National Provider Identifier
1245405232
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012912 Issued in IL
Practice address
136 Burton St
Grayslake, IL 60030-1508
Phone
(224) 430-9804
NPI assigned
Apr 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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 149.012912 IL Primary

Addresses

Primary practice location

136 Burton St
Grayslake, IL 60030-1508

Mailing address

136 Burton St
Grayslake, IL 60030-1508
Phone (224) 430-9804

Other names 1

  • Ms. Linda Rosenberg Former name

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
I20140424001013 IL Practitioner - Clinical Social Worker 3476786641 Practice locations: Grayslake, IL; Lake Bluff, IL; Lake Villa, IL; Vernon Hills, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

34930 N Hwy 45
Suite 101
Lake Villa, IL 60046
Phone (224) 430-9804

977 Harris Rd
Unit 22
Grayslake, IL 60030-3566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.012912ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kimberly a. Kick, LCSW & Associates, LTD. Past Accepting new patients

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": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398297600000",
    "number": "1245405232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 BURTON ST",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301508",
            "telephone_number": "224-430-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 BURTON ST",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301508",
            "telephone_number": "224-430-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEHAN",
        "first_name": "LINDA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2014-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "ROSENBERG",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grayslake, IL

Sources for this page

Verify at the official NPI Registry.