Susan Lucille Mellema, LCSW
Social Worker, Clinical in North Aurora, IL. Individual provider (NPI-1).
NPI number1700614948
StatusActive
Last updated in NPPESJul 22, 2024
Details
- NPI
- 1700614948
- Entity type
- Individual (NPI-1)
- Name
- Susan Lucille Mellema
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 22, 2024
- Certification date
- Jul 21, 2024
- Last updated
- Jul 22, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 149011313 | IL | Yes |
Practice location
711 Hidden Creek LnNorth Aurora, IL 60542-1165
Phone 630-291-3005
Mailing address
711 Hidden Creek LnNorth Aurora, IL 60542-1165
Phone 630-291-3005
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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