Individual provider Active NPI

Marcellina Stuart, LCSW

  • Clinical Social Worker
  • Antioch, IL
National Provider Identifier
1992870133
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.019538 Issued in IL
Practice address
311 W Depot St Ste M
Antioch, IL 60002-1500
Phone
(331) 725-1190
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 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 150011445 IL
Clinical Social Worker 1041C0700X 149.019538 IL Primary

Addresses

Primary practice location

311 W Depot St Ste M
Antioch, IL 60002-1500

Mailing address

311 W Depot St Ste M
Antioch, IL 60002-1500
Phone (331) 725-1190

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
I20251217002869 IL Practitioner - Clinical Social Worker 9638664642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

311 W Depot St
Suite M
Antioch, IL 60002-1500
Phone (331) 725-1190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150011445ILMDSocial Worker
149.019538ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Leaf Counseling Social Worker CurrentSince Oct 22, 2025 Accepting new patients

Locations

311 W Depot St
Ste M
Antioch, IL 60002
Phone (331) 725-1190

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.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1992870133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W DEPOT ST STE M",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021500",
            "telephone_number": "331-725-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W DEPOT ST STE M",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021500",
            "telephone_number": "331-725-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "MARCELLINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150011445",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, IL

Sources for this page

Verify at the official NPI Registry.