Individual provider Active NPI

Courtney Hickey, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1922557404
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.021656 Issued in IL
Practice address
5547 N Ravenswood Ave # 201
Chicago, IL 60640-1125
Phone
(773) 349-2466
NPI assigned
Sep 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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 149.021656 IL Primary

Addresses

Primary practice location

5547 N Ravenswood Ave # 201
Chicago, IL 60640-1125

Mailing address

5547 N Ravenswood Ave # 201
Chicago, IL 60640-1125

Other practice location 1

836 W Wellington Ave
Chicago, IL 60657-5147
Phone (224) 280-5866

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
I20230606000547 IL Practitioner - Clinical Social Worker 1052778164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridgepoint Psychology Center IncGroup PAC ID 6406278845, 6 clinicians

Practice addresses (Care Compare)

5547 N Ravenswood Ave
Suite 201
Chicago, IL 60640-1125
Phone (773) 349-2466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgepoint Psychology Center Inc. CurrentSince Feb 15, 2024 Accepting new patients
Youth Outreach Services Past Accepting new patients
Youth Outreach Services Past Accepting new patients

Locations

5547 N Ravenswood Ave
#201
Chicago, IL 60640
Phone (773) 349-2466

5547 N Ravenswood Ave
Ste 201
Chicago, IL 60640
Phone (773) 219-0484

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1922557404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5547 N RAVENSWOOD AVE # 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5547 N RAVENSWOOD AVE # 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401125",
            "telephone_number": "773-349-2466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "836 W Wellington Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575147",
            "country_code": "US",
            "telephone_number": "224-280-5866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "COURTNEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-26",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.