Individual provider Active NPI

Shannon Warnicki, LCSW

  • Clinical Social Worker
  • Romeoville, IL
National Provider Identifier
1275970808
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015704 Issued in IL
Practice address
30 Phelps Ave
Romeoville, IL 60446-1335
Phone
(815) 409-5363
NPI assigned
May 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 149015704 IL
Clinical Social Worker 1041C0700X 149015704 IL Primary

Addresses

Primary practice location

30 Phelps Ave
Romeoville, IL 60446-1335

Mailing address

30 Phelps Ave
Romeoville, IL 60446-1335
Phone (815) 409-5363

Other practice location 1

7670 Marmora Ave
Skokie, IL 60077-2628
Phone (847) 967-1800 ext. 153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149015704ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Individual Advocacy Group, Inc. CurrentSince Aug 13, 2023 Accepting new patients
A New Day Counseling & Family Wellness, Inc. NFP Clinical CurrentSince Jan 25, 2024 Accepting new patients
A New Day Family Counseling Clinical Past Accepting new patients

Locations

23908 W Main St
Plainfield, IL 60544
Phone (815) 683-8700

30 Phelps Ave
Romeoville, IL 60446
Phone (630) 755-0053

1289 Windham Pkwy
Romeoville, IL 60446
Phone (630) 759-0201

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1275970808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PHELPS AVE",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461335",
            "telephone_number": "815-409-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PHELPS AVE",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461335",
            "telephone_number": "815-409-5363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7670 Marmora Ave",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600772628",
            "country_code": "US",
            "telephone_number": "847-967-1800 x153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARNICKI",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-22",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "149015704",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Romeoville, IL

Sources for this page

Verify at the official NPI Registry.