MEDICARE: MS. MONICA N SMITH MSW, LCSW, PEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041S0200X	School Social Worker	1807686	IL
2	1041C0700X	Clinical Social Worker	149.020993	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528530151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONICA N SMITH MSW, LCSW, PEL

Provider Business Mailing Address
First Line	:	2405 ESSINGTON RD STE B1041
Second Line	:
City	:	JOLIET
State	:	IL
Zip	:	60435-1200
Country	:	US
Telephone Number	:	815-901-4722
Fax Number	:

Provider Business Practice Location Address
First Line	:	2405 ESSINGTON RD STE B1041
Second Line	:
City	:	JOLIET
State	:	IL
Zip	:	60435-1200
Country	:	US
Telephone Number	:	815-901-4722
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2018
Last Update Date	:	10/03/2025

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