Jessica L McClellan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.021411 Issued in IL

Practice address

1204 E Oak St Ste 2-2
Mahomet, IL 61853-2795

Phone

(217) 530-5608

NPI assigned

Aug 7, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grit and Grace Therapy PLLCGroup PAC ID 2062889371, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grit and Grace Therapy PLLC

  • Clinical Social Worker
  • Mahomet, IL
  • NPI 1013666015
  Medicare reassignment Care Compare group NPD Authorized official
• Keri Powell Therapy Inc

  • Mental Health Counselor
  • Champaign, IL
  • NPI 1174751663

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1487209359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 E OAK ST STE 2-2",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618532795",
            "telephone_number": "217-530-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 E OAK ST STE 2-2",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618532795",
            "telephone_number": "217-530-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MBS Envision, Inc
• Mariah L McAnally, LSW
• Wendy Bordoff McCaughrin, PH.D CCC-SLP
• Marcie Diane McClain, M.A., CCC-SLP
• Casie Danielle McClellan, MSN, APRN, FNP-C
• Katie McKinney, MR, RD, CSSD, LDN
• Randall A Megeff, MD
• Noelle E Meyer, DPT
• Kathryn Elaine Miller Rose
• Amelia K Miller

• Clinical Social Worker in Mahomet, IL
• Providers in Mahomet, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.