Active NPI
Nicole M Lee, LSW
- Social Worker
- Champaign, IL
National Provider Identifier
1700550498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150117089
- Practice address
- 2506 Fields South Dr Apt 304
Champaign, IL 61822-3715 - Phone
- (217) 203-2008
- Fax
- (844) 412-7089
- NPI assigned
- Aug 5, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 150117089 | IL | Primary |
Addresses
Primary practice location
2506 Fields South Dr Apt 304
Champaign, IL 61822-3715
Mailing address
PO Box 162
Paxton, IL 60957-0162
Phone (217) 379-4302
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150117089 | IL | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Champaign Counseling LLC | Past | Accepting new patients | |
| Community Resource & Counseling Center Inc | Past | Accepting new patients |
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.
-
- Clinical Social Worker
- Savoy, IL
- NPI 1770938359
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Paxton, IL
- NPI 1972567261
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752451200000",
"number": "1700550498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 162",
"city": "PAXTON",
"state": "IL",
"postal_code": "609570162",
"telephone_number": "217-379-4302",
"fax_number": "217-817-0379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2506 FIELDS SOUTH DR APT 304",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618223715",
"telephone_number": "217-203-2008",
"fax_number": "844-412-7089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "NICOLE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-05",
"last_updated": "2025-07-14",
"certification_date": "2025-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150117089",
"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 Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.