Active NPI
Melissa Larson
- Clinical Social Worker
- Somonauk, IL
National Provider Identifier
1699392001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149022152
- Practice address
- 400 E North St
Somonauk, IL 60552-3162 - Phone
- (815) 579-4581
- NPI assigned
- Jul 1, 2020
- Sex
- Female
- 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 | 149022152 | IL | Primary |
Addresses
Primary practice location
400 E North St
Somonauk, IL 60552-3162
Mailing address
400 E North St
Somonauk, IL 60552-3162
Phone (815) 579-4581
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260216002881 | IL | Practitioner - Clinical Social Worker | 5890275168 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2006
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
23908 W Main St
Plainfield, IL 60544-2122
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149022152 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A New Day Counseling & Family Wellness, Inc. NFP | Clinical | Current | Accepting new patients |
Locations
23908 W Main St
Plainfield, IL 60544
Phone (815) 683-8700
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.
-
- Clinical Social Worker
- Plainfield, IL
- NPI 1275296899
Clinical, IL
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593561600000",
"number": "1699392001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E NORTH ST",
"city": "SOMONAUK",
"state": "IL",
"postal_code": "605523162",
"telephone_number": "815-579-4581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E NORTH ST",
"city": "SOMONAUK",
"state": "IL",
"postal_code": "605523162",
"telephone_number": "815-579-4581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "MELISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-01",
"last_updated": "2020-07-01",
"certification_date": "2020-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149022152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somonauk, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.