Individual provider Active NPI

Jessica West, LCSW

  • Clinical Social Worker
  • Dixon, IL
National Provider Identifier
1770147506
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149022479 Issued in IL
Practice address
446 River Bluff Dr
Dixon, IL 61021-8768
Phone
(815) 677-6280
NPI assigned
Apr 26, 2019
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 149022479 IL Primary

Addresses

Primary practice location

446 River Bluff Dr
Dixon, IL 61021-8768

Mailing address

446 River Bluff Dr
Dixon, IL 61021-8768
Phone (815) 677-6280

Other practice location 1

303 N Jackson St
Morrison, IL 61270-3042
Phone (815) 772-4003

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201111000062 IL Practitioner - Clinical Social Worker 1052721644 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

303 N Jackson St
Morrison, IL 61270-3042
Phone (815) 772-4003

657 W Lincolnway
Morrison, IL 61270-2056
Phone (815) 772-5567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
KSB Medical Group, Inc. CurrentSince Aug 25, 2020 Accepting new patients
KSB Medical Group, Inc. CurrentSince Aug 25, 2020 Accepting new patients
Bloom Space Counseling, PLLC Clinical CurrentSince Feb 2, 2025 Accepting new patients
Morrison Community Hospital District Current Accepting new patients
Morrison Community Hospital District CurrentSince Nov 11, 2023 Accepting new patients

Locations

144 North Ct
Dixon, IL 61021
Phone (815) 284-7733

215 E 1st St
Ste 111
Dixon, IL 61021
Phone (815) 285-5477

403 E 1st St
Dixon, IL 61021
Phone (815) 285-5629

303 N Jackson St
Morrison, IL 61270
Phone (815) 772-4003

657 W Lincolnway
Morrison, IL 61270
Phone (815) 772-4003

Interoperability endpoints

  • Direct secure messaging: jessicawest@mchospital.medalliesdirect.net

Organizations & group practices 5

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.

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": "1737936000000",
    "number": "1770147506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 RIVER BLUFF DR",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610218768",
            "telephone_number": "815-677-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 RIVER BLUFF DR",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610218768",
            "telephone_number": "815-677-6280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 N Jackson St",
            "address_purpose": "LOCATION",
            "city": "Morrison",
            "state": "IL",
            "postal_code": "612703042",
            "country_code": "US",
            "telephone_number": "815-772-4003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEST",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-26",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149022479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.