Individual provider Active NPI

Malory Goldin Ceaser, LCSW

  • Clinical Social Worker
  • Northbrook, IL
National Provider Identifier
1366176646
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.022951 Issued in IL
Practice address
60 Revere Dr Ste 100
Northbrook, IL 60062-1590
Phone
(224) 306-1879
Fax
(224) 306-1878
NPI assigned
Jul 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 200003150 DC
Clinical Social Worker 1041C0700X 09929082 CO
Clinical Social Worker 1041C0700X 0904015259 VA
Clinical Social Worker 1041C0700X 149.022951 IL Primary
Clinical Social Worker 1041C0700X 34929 MN

Addresses

Primary practice location

60 Revere Dr Ste 100
Northbrook, IL 60062-1590

Mailing address

60 Revere Dr Ste 100
Northbrook, IL 60062-1590
Phone (224) 306-1879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
09929082COMDClinical Social Worker
200003150DCMDClinical Social Worker
149.022951ILMDClinical Social Worker
34929MNMDClinical Social Worker
0904015259VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1366176646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 REVERE DR STE 100",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621590",
            "telephone_number": "224-306-1879",
            "fax_number": "224-306-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 REVERE DR STE 100",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621590",
            "telephone_number": "224-306-1879",
            "fax_number": "224-306-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEASER",
        "first_name": "MALORY",
        "middle_name": "GOLDIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "200003150",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09929082",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904015259",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.022951",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "34929",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.