Organization Active NPI

Helen Woodrum LCSW PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dixon, IL
National Provider Identifier
1740958297
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HELEN WOODRUM LCSW PLLC
Practice address
114 E Everett St Ste 208
Dixon, IL 61021-2140
Phone
(815) 994-6400
NPI assigned
Aug 31, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Authorized official

Name
Ms. Helen R Woodrum, LCSWNPI 1881986636
Title
Owner, Therapist
Phone
(815) 277-1049

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

114 E Everett St Ste 208
Dixon, IL 61021-2140

Mailing address

114 E Everett St Ste 208
Dixon, IL 61021-2140
Phone (815) 994-6400

Other identifiers 3

IdentifierTypeStateIssuer
149015750OtherILIL DEPT. FINANCIAL AND PROF. REGULATION
149015750OtherILILLINOIS DEPARTMENT OF PROFESSIONAL REGULATION- LCSW
12588016OtherILCAQH

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://helen-woodrum.clientsecure.me/ Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211209001275 IL Part B Supplier - Clinic/Group Practice 2567852312 Receives reassigned benefits from 1 practitioner
Practice locations: Dixon, IL

National Provider Directory

National Provider Directory

Locations

114 E Everett St
Ste 208
Dixon, IL 61021
Phone (815) 277-1049

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1740958297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E EVERETT ST STE 208",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610212140",
            "telephone_number": "815-994-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E EVERETT ST STE 208",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610212140",
            "telephone_number": "815-994-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HELEN WOODRUM LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "WOODRUM",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "815-277-1049",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL DEPT. FINANCIAL AND PROF. REGULATION",
            "identifier": "149015750",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPARTMENT OF PROFESSIONAL REGULATION- LCSW",
            "identifier": "149015750",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12588016",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://helen-woodrum.clientsecure.me/",
            "affiliation": "N",
            "endpointDescription": "Business Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "114 E Everett St Ste 208",
            "city": "Dixon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "610212140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.