Erin Nicole Doherty, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.026778 Issued in IL

Practice address

500 Brown Blvd
Bourbonnais, IL 60914-2328

Phone

(262) 902-0915

NPI assigned

Oct 15, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Collective Balance Counseling, LLCGroup PAC ID 5597287938, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Collective Balance Counseling, LLC

  • Mental Health Counselor
  • Bourbonnais, IL
  • NPI 1265998058
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1336969146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5811 WILDWOOD DR",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534039727",
            "telephone_number": "262-902-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 BROWN BLVD",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142328",
            "telephone_number": "262-902-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "ERIN",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Vogt Digiacomo, PSY.D.
• Christopher Digiovanni, LCSW
• Joslynn Denise Dillard-Greene
• Katelyn E Dircks, MSW, LCSW
• Jon E Dodds, LCPC
• Erin Margaret Domzalski, DT
• Timothy E Donnelly, PT
• Jaden Doran
• Doreena M McBride MD PC
• Courtney Doyle

• Clinical Social Worker in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.