Individual provider Active NPI

Grace Mooney-Melvin, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1619798386
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149019904 Issued in IL
Practice address
1725 W Harrison St Ste 340
Chicago, IL 60612-3852
Phone
(312) 563-3913
NPI assigned
Oct 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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 149019904 IL Primary

Addresses

Primary practice location

1725 W Harrison St Ste 340
Chicago, IL 60612-3852

Mailing address

1725 W Harrison St Ste 340
Chicago, IL 60612-3852
Phone (312) 563-3913

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
149019904ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Nov 30, 2024 Accepting new patients
Rush University Medical Center CurrentSince Nov 30, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1725 W Harrison St
Ste 340
Chicago, IL 60612
Phone (312) 563-9805

1520 W Harrison St
Chicago, IL 60607
Phone (312) 226-2371

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

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": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1619798386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 340",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123852",
            "telephone_number": "312-563-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 340",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123852",
            "telephone_number": "312-563-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY-MELVIN",
        "first_name": "GRACE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.