Michael E Blea
Individual provider Active NPI Clinical Social Worker · Johnsburg, IL
NPI 1457030165 · NPPES record last updated Mar 24, 2025
Key facts
- NPI
- 1457030165
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 149.026204 (IL)
- Practice address
- 4210 Ella LN
Johnsburg, IL 60051-5433 - Phone
- (815) 995-0306
- NPI assigned
- Jul 12, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5443 Bull Valley Rd
McHenry, IL 60050-7410
Phone (815) 995-0306
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240523003490 | IL | Practitioner - Clinical Social Worker | 0244672194 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.026204 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clear Springs Therapy PLLC | Clinical | Current |
Accepting new patients |
Locations
5443 Bull Valley Rd
McHenry, IL 60050
Phone (224) 888-2662
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.026204 | IL | Yes |
Addresses
Primary practice location
4210 Ella LN
Johnsburg, IL 60051-5433
Mailing address
4210 Ella LN
Johnsburg, IL 60051-5433
Phone (815) 995-0306
Other providers in Johnsburg, IL
- Joslynn Adams
- Aroop Banerji
- Kathleen Blount
- Center for Emotional Wellness of the Northwest Suburbs
- Chiro One Wellness Center of McHenry LLC
- Clear Springs Therapy PLLC
- Crossroads Counseling Center LLC
All providers in Johnsburg, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.