Shawn Nowotnik, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149023973 Issued in IL

Practice address

100 Illinois St
St Charles, IL 60174-1866

Phone

(331) 575-4858

Fax

(708) 468-4991

NPI assigned

Nov 18, 2021

Last updated

Nov 18, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Lavender Clinical Services LLCGroup PAC ID 7214306661, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Lavender Clinical Services LLC

  • Community/Behavioral Health Agency
  • St Charles, IL
  • NPI 1932879459
  Medicare reassignment Care Compare group NPD
• Psychotherapy Today, LLC

  • Clinical Social Worker
  • Montgomery, IL
  • NPI 1578434627
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1740947373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ILLINOIS ST STE 200",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741867",
            "telephone_number": "331-575-4858",
            "fax_number": "708-468-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ILLINOIS ST",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741866",
            "telephone_number": "331-575-4858",
            "fax_number": "708-468-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWOTNIK",
        "first_name": "SHAWN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149023973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David J. Norton, PH.D.
• Gracia Nosewicz
• Novo: Renewing Joy in Life, PC
• Thalia Novoa, LCPC
• Tamara M Nowak, L.S.W., C.A.D.C, J.D
• Nyuli Chiropractic, P.C.
• John M. Nyuli, DC
• Katelyn Lee O'Connell, LSW
• Sarah Elsa O'Connor, M.S. CCC-SLP
• Sheila Anne O'Connor, MOT, OTR-L

• Clinical Social Worker in St Charles, IL
• Providers in St Charles, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.

Verify at the official NPI Registry.