Individual provider Active NPI

David McDaniel, LSW

  • Clinical Social Worker
  • Champaign, IL
National Provider Identifier
1669036489
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.024629 Issued in IL
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

Updated by the provider on Mar 18, 2026

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 149.024629 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

LicenseStateTypeSpecialty
149.024629ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bodhi Counseling & Consulting Center, PC CurrentSince Oct 1, 2023 Accepting new patients
Steadfast Center LLC PastSince Mar 1, 2020 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.

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

Verify at the official NPI Registry.