Stephanie Aguilera-Mendoza, LSW

Individual provider Active NPI Mental Health Counselor · Wheaton, IL

NPI 1780469411 · NPPES record last updated Aug 30, 2023

Key facts

NPI
1780469411
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
150.110840 (IL)
Practice address
111 N County Farm Rd
Wheaton, IL 60187-3977
Phone
(630) 682-7400
NPI assigned
Aug 30, 2023
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

111 N County Farm Rd
Wheaton, IL 60187-3977

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260529000765 IL Practitioner - Clinical Social Worker 7618447749 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
150.110840ILMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 150.110840 IL Yes

Addresses

Primary practice location

111 N County Farm Rd
Wheaton, IL 60187-3977

Mailing address

111 N County Farm Rd
Wheaton, IL 60187-3977

Other providers in Wheaton, IL

All providers in Wheaton, IL · Mental Health Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.