Individual provider Active NPI

Nicol Kayla Igoche, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1366110165
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.028892 Issued in IL
Practice address
125 E 21St St Apt 112
Chicago, IL 60616-1702
Phone
(845) 641-9418
NPI assigned
Sep 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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 149.028892 IL Primary

Addresses

Primary practice location

125 E 21St St Apt 112
Chicago, IL 60616-1702

Mailing address

125 E 21St St Apt 112
Chicago, IL 60616-1702
Phone (845) 641-9418

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
I20221205001754 IL Practitioner - Clinical Social Worker 8224407705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10502 Fountain Lake Dr
Stafford, TX 77477-3708

300 Lenora St LLC PMB
Suite 1348
Seattle, WA 98121-2411

91 -1159 Kamakana St
Apt 109
Ewa Beach, HI 96706-6419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.028892ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Black Space LLC Mental Health CurrentSince Jun 2, 2025 Accepting new patients
Open Mind Counseling Services Inc Mental Health CurrentSince Aug 10, 2022 Accepting new patients

Locations

1701 E Woodfield Rd
Ste 400
Schaumburg, IL 60173
Phone (224) 269-4551

1701 E Woodfield Rd
Ste 435
Schaumburg, IL 60173
Phone (224) 269-4549

300 Lenora St
Seattle, WA 98121
Phone (206) 623-7671

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": "1630886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1366110165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E 21ST ST APT 112",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161702",
            "telephone_number": "845-641-9418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E 21ST ST APT 112",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161702",
            "telephone_number": "845-641-9418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGOCHE",
        "first_name": "NICOL",
        "middle_name": "KAYLA",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-06",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.028892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.