MEDICARE: DR. CATHLEEN SHANE BENDICSEN LCSW

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	1041C0700X	Clinical Social Worker	149.016412	IL

General Provider Information

NPI Number	:	1649123621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHLEEN SHANE BENDICSEN LCSW

Provider Business Mailing Address
First Line	:	946 MAIN ST
Second Line	:
City	:	BATAVIA
State	:	IL
Zip	:	60510-2791
Country	:	US
Telephone Number	:	630-728-9033
Fax Number	:

Provider Business Practice Location Address
First Line	:	946 MAIN ST
Second Line	:
City	:	BATAVIA
State	:	IL
Zip	:	60510-2791
Country	:	US
Telephone Number	:	630-728-9033
Fax Number	:

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

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

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