Individual provider Active NPI

Danielle Yocum, LCSW

  • Clinical Social Worker
  • Peoria, IL
National Provider Identifier
1285198978
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.019560 Issued in IL
Practice address
900 Main St Ste 580
Peoria, IL 61602-1065
Phone
(309) 637-4266
NPI assigned
Jan 26, 2019
Last updated
Mar 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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 149.019560 IL Primary

Addresses

Primary practice location

900 Main St Ste 580
Peoria, IL 61602-1065

Mailing address

24 S 6TH Ave
Canton, IL 61520-2833
Phone (309) 224-7064

Other names 1

  • Danielle Madtson 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
I20190613001928 IL Practitioner - Clinical Social Worker 8426381005 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.019560ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Graham Hospital Association CurrentSince May 1, 2024 Accepting new patients
Joy Miller CurrentSince Jul 1, 2022 Accepting new patients
Graham Hospital Association CurrentSince May 1, 2024 Accepting new patients
Graham Hospital Association Current Accepting new patients
Associates in Mental Health, SC Clinical PastSince Jan 1, 1992 Accepting new patients

Locations

175 S Main St
Canton, IL 61520
Phone (309) 647-3937

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

7617 N Villa Wood Ln
Peoria, IL 61614
Phone (309) 693-8200

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1548460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1285198978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 S 6TH AVE",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202833",
            "telephone_number": "309-224-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 580",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021065",
            "telephone_number": "309-637-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOCUM",
        "first_name": "DANIELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-26",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "MADTSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.