Individual provider Active NPI

Megan Gray-Gordon, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1609378462
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012522 Issued in IL
Practice address
1015 W Lawrence Ave FL 2
Chicago, IL 60640-5017
Phone
(773) 275-2586
NPI assigned
Mar 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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 149.012522 IL Primary

Addresses

Primary practice location

1015 W Lawrence Ave FL 2
Chicago, IL 60640-5017

Mailing address

2439 N Albany Ave Apt 1S
Chicago, IL 60647-2601

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
I20220907001844 IL Practitioner - Clinical Social Worker 5092199240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mosaic Counseling and Wellness LLCGroup PAC ID 1355728353, 29 clinicians

Practice addresses (Care Compare)

386 N York St
Elmhurst, IL 60126-2363
Phone (312) 213-7862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.012522ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Counseling and Wellness LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

386 N York St
Elmhurst, IL 60126
Phone (312) 213-7862

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1609378462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2439 N ALBANY AVE APT 1S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 W LAWRENCE AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405017",
            "telephone_number": "773-275-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY-GORDON",
        "first_name": "MEGAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.