Active NPI
David McDaniel, LSW
- Clinical Social Worker
- Champaign, IL
National Provider Identifier
1669036489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.024629
- Practice address
- 505 W University Ave Ste 225
Champaign, IL 61820-3915 - Phone
- (217) 390-2247
- Fax
- (309) 839-4465
- NPI assigned
- Apr 26, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.024629 | IL | Primary |
Addresses
Primary practice location
505 W University Ave Ste 225
Champaign, IL 61820-3915
Mailing address
505 W University Ave Ste 225
Champaign, IL 61820-3915
Phone (217) 390-2247
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 15, 2022 through Jun 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.024629 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bodhi Counseling & Consulting Center, PC | Current | Accepting new patients | |
| Steadfast Center LLC | Past | Accepting new patients |
Locations
100 Trade Centre Dr
Ste 302
Champaign, IL 61820
Phone (217) 731-4638
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.
-
- Community/Behavioral Health Agency
- Champaign, IL
- NPI 1013684901
-
- Mental Health Counselor
- Champaign, IL
- NPI 1659855997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773792000000",
"number": "1669036489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 W UNIVERSITY AVE STE 225",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203915",
"telephone_number": "217-390-2247",
"fax_number": "309-839-4465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 W UNIVERSITY AVE STE 225",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203915",
"telephone_number": "217-390-2247",
"fax_number": "309-839-4465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDANIEL",
"first_name": "DAVID",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-26",
"last_updated": "2026-03-18",
"certification_date": "2026-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.024629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.