Individual provider Active NPI

Damen Wellen, LCSW

  • Clinical Social Worker
  • Highland Park, IL
National Provider Identifier
1518325398
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801116038 Issued in MI
Practice address
814 Timber Hill Rd
Highland Park, IL 60035-5121
Phone
(646) 621-3743
NPI assigned
Feb 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801116038 MI Primary
Clinical Social Worker 1041C0700X 149019993 IL
Clinical Social Worker 1041C0700X 29526 AR

Addresses

Primary practice location

814 Timber Hill Rd
Highland Park, IL 60035-5121

Mailing address

814 Timber Hill Rd
Highland Park, IL 60035-5121
Phone (646) 621-3743

Other practice location 1

105 N 1st St
Augusta, AR 72006-2307
Phone (870) 731-1063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250529002211 MI Practitioner - Clinical Social Worker 6608395959 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149019993ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince Jun 20, 2025 Accepting new patients
Manatee Care Past Accepting new patients

Locations

400 Renaissance Ctr
Detroit, MI 48243
Phone (248) 599-1582

Organizations & group practices 2

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": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1518325398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 TIMBER HILL RD",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355121",
            "telephone_number": "646-621-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 TIMBER HILL RD",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355121",
            "telephone_number": "646-621-3743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "AR",
            "postal_code": "720062307",
            "country_code": "US",
            "telephone_number": "870-731-1063",
            "fax_number": "870-731-1064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLEN",
        "first_name": "DAMEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801116038",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019993",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "29526",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

Verify at the official NPI Registry.