Dawn Heather McCollom, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.012197 Issued in IL

Practice address

601 W Norris Dr
Suite B
Ottawa, IL 61350-1381

Phone

(815) 433-5101

Fax

(815) 433-5102

NPI assigned

Jul 10, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Dawn Heather Mills Former name

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Illinois Valley Counseling ServicesGroup PAC ID 0244467066, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Illinois Valley Counseling Services

  • Clinical Social Worker
  • Ottawa, IL
  • NPI 1134568249
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325376000000",
    "number": "1841454766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 N DIVISION ST",
            "address_2": "SUITE 604",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501182",
            "telephone_number": "815-941-3882",
            "fax_number": "815-941-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W NORRIS DR",
            "address_2": "SUITE B",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501381",
            "telephone_number": "815-433-5101",
            "fax_number": "815-433-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLOM",
        "first_name": "DAWN",
        "middle_name": "HEATHER",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2012-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "MILLS",
            "middle_name": "HEATHER",
            "prefix": "MISS",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brenda Ann Mason, LCPC
• Laura Linnea Mason, MPT
• Kelissa Jo Mateika, COTA
• Sarah Mathieu
• Robert J Maziarka, PHARMD
• John Emmett McLachlan, RPH
• Collin Shanley McLean, PA-C
• Meghan McNamara
• Leo John Meagher, MA PSYCHOLOGY
• Medi-RX Pharmacy, Inc

• Clinical Social Worker in Ottawa, IL
• Providers in Ottawa, 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 Jan 1, 2012; 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.