Individual provider Active NPI

Tenilya S Mumphus, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1255086641
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.024114 Issued in IL
Practice address
3348 W 87TH St
Chicago, IL 60652-3767
Phone
(773) 776-4471
NPI assigned
Feb 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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 149.024114 IL Primary

Addresses

Primary practice location

3348 W 87TH St
Chicago, IL 60652-3767

Mailing address

PO Box 746715
Atlanta, GA 30374-6715
Phone (773) 352-1515

Other practice location 1

2409 N Clybourn Ave
Chicago, IL 60614-6185
Phone (773) 270-1652

Other practice location 2

2017 W Morse Ave Unit E2
Chicago, IL 60645-4954
Phone (773) 415-3229

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL DHS Direct

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
I20230217000892 IL Practitioner - Clinical Social Worker 0244602365 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
Oak Street Health Physicians Group PCGroup PAC ID 7517109879, 227 clinicians

Practice addresses (Care Compare)

3348 W 87TH St
Chicago, IL 60652-3767
Phone (312) 733-9730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.024114ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group, PC CurrentSince Feb 6, 2023 Accepting new patients
Mindful Moments Clinical Current Accepting new patients

Locations

3348 W 87th St
Chicago, IL 60652
Phone (773) 776-4471

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

16649 Oak Park Ave
Ste H
Tinley Park, IL 60477
Phone (708) 249-7301

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": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1255086641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746715",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746715",
            "telephone_number": "773-352-1515",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3348 W 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606523767",
            "telephone_number": "773-776-4471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2409 N Clybourn Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606146185",
            "country_code": "US",
            "telephone_number": "773-270-1652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2017 W Morse Ave Unit E2",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606454954",
            "country_code": "US",
            "telephone_number": "773-415-3229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUMPHUS",
        "first_name": "TENILYA",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "DHS",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2409 N Clybourn Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606146185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.