Individual provider Active NPI

Tina McCue, LCSW

  • Clinical Social Worker
  • North Aurora, IL
National Provider Identifier
1902416852
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.021955 Issued in IL
Practice address
66 Miller Dr Ste 104
North Aurora, IL 60542-5144
Phone
(630) 587-3777
NPI assigned
Aug 5, 2020
Last updated
Aug 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.021955 IL Primary

Addresses

Primary practice location

66 Miller Dr Ste 104
North Aurora, IL 60542-5144

Mailing address

PO Box 3055
St Charles, IL 60174-9099
Phone (630) 587-3777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • 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
I20241017002649 IL Practitioner - Clinical Social Worker 3072045848 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.021955ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Agency of Dekalb County, Inc. CurrentSince Jul 6, 2024 Accepting new patients
Family Service Agency of Dekalb County, Inc. CurrentSince Jul 6, 2024 Accepting new patients
Riverview Counseling Services, LTD. Clinical PastSince Aug 9, 2020 Accepting new patients

Locations

1325 Sycamore Rd
DeKalb, IL 60115
Phone (815) 758-8616

Organizations & group practices 3

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": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1902416852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3055",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601749099",
            "telephone_number": "630-587-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 MILLER DR STE 104",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605425144",
            "telephone_number": "630-587-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUE",
        "first_name": "TINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Aurora, IL

Sources for this page

Verify at the official NPI Registry.