Individual provider Active NPI

Tammy Dahlke, LSW

  • Social Worker
  • Mattoon, IL
National Provider Identifier
1376159970
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150111340 Issued in IL
Practice address
750 Broadway Ave E
Mattoon, IL 61938-4610
Phone
(217) 238-5700
NPI assigned
Sep 18, 2020
Last updated
Nov 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150111340 IL Primary

Addresses

Primary practice location

750 Broadway Ave E
Mattoon, IL 61938-4610

Mailing address

750 Broadway Ave E
Mattoon, IL 61938-4610
Phone (217) 238-5700

Other identifiers 1

IdentifierTypeStateIssuer
150000340OtherILLICENSE

Other names 1

  • Tammy Bailey Former name

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.

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

750 Broadway Ave E
Mattoon, IL 61938-4610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150111340ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Coles County Mental Health Association, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1376159970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 BROADWAY AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384610",
            "telephone_number": "217-238-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BROADWAY AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384610",
            "telephone_number": "217-238-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLKE",
        "first_name": "TAMMY",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150111340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "150000340",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "BAILEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.