Individual provider Active NPI

Thomas Cicero, LCSW

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1609492933
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
149022241 Issued in IL
Practice address
3950 N Lake Shore Dr Apt 1310B
Chicago, IL 60613-3491
Phone
(312) 420-9256
NPI assigned
Jun 23, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 149022241 IL Primary

Addresses

Primary practice location

3950 N Lake Shore Dr Apt 1310B
Chicago, IL 60613-3491

Mailing address

3950 N Lake Shore Dr Apt 1310B
Chicago, IL 60613-3491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149022241ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Mar 27, 2023 Accepting new patients
Blue Moon Senior Counseling of Illinois LLC Multi-Specialty CurrentSince Sep 13, 2023 Accepting new patients
Midwest Post Acute Care PLLC Multi-Specialty CurrentSince Jul 13, 2020 Accepting new patients

Locations

1366 W Fullerton Ave
Chicago, IL 60614
Phone (630) 734-0640

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

2045 W Grand Ave
Ste B
Chicago, IL 60612
Phone (800) 827-7437

10204 Bode St
Ste C
Plainfield, IL 60585
Phone (630) 844-7077

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": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1609492933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 N LAKE SHORE DR APT 1310B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 N LAKE SHORE DR APT 1310B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133491",
            "telephone_number": "312-420-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICERO",
        "first_name": "THOMAS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149022241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.