Individual provider Active NPI

Katherine Morge Lueken, LCSW

  • Clinical Social Worker
  • Dekalb, IL
National Provider Identifier
1407183155
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149013923 Issued in IL
Practice address
12 Health Services Dr
Dekalb, IL 60115-9637
Phone
(815) 756-4875
Fax
(815) 756-2944
NPI assigned
Nov 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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 149013923 IL Primary

Addresses

Primary practice location

12 Health Services Dr
Dekalb, IL 60115-9637

Mailing address

12 Health Services Dr
Dekalb, IL 60115-9637
Phone (815) 756-4875

Other names 1

  • Katherine Lynn Morge 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
I20100505000752 IL Practitioner - Clinical Social Worker 4284762691 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Behavioral Health Foundation, Inc. CurrentSince Nov 8, 2015 Accepting new patients
Dekalb Behavioral Health Foundation, Inc. CurrentSince Nov 8, 2015 Accepting new patients
Kishwaukee Community Hospital Past Accepting new patients

Locations

631 S 1st St
DeKalb, IL 60115
Phone (815) 756-4875

12 Health Services Dr
DeKalb, IL 60115
Phone (815) 756-4875

Organizations & group practices 3

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": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1407183155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HEALTH SERVICES DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159637",
            "telephone_number": "815-756-4875",
            "fax_number": "815-756-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HEALTH SERVICES DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159637",
            "telephone_number": "815-756-4875",
            "fax_number": "815-756-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEKEN",
        "first_name": "KATHERINE",
        "middle_name": "MORGE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "MORGE",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dekalb, IL

Sources for this page

Verify at the official NPI Registry.