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MARY E TICKNOR LCSW, LICSW
NPI 1003857079
Social Worker - Clinical in Chicago, IL

Active since June 09, 2006PECOS EnrolledAccepts Medicare Assignment
1720 N LA SALLE DR APT 22, CHICAGO, IL 60614(413) 374-6135(888) 335-8179 Get Directions Write a Review

NPPES record last updated: February 9, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 9, 2023, Apr 28, 2017 (2 updates tracked since 2017).

About Mary E Ticknor Lcsw, Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY E TICKNOR LCSW, LICSW (NPI 1003857079) is an individual clinical provider in Chicago, Illinois, licensed in Massachusetts (113177) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS, maintains a secondary practice location in Park Ridge, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1003857079
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMARY E TICKNORCredential: LCSW, LICSW
Location Address1720 N LA SALLE DR APT 22Chicago, IL 60614-5845
Mailing Address1720 N La Salle Dr Apt 22Chicago, IL 60614-5845 · (413) 374-6135 · Fax (888) 335-8179
Phone(413) 374-6135
Fax(888) 335-8179
Sole ProprietorYes
Medical School CMSOtherGraduated 2002
Enumeration DateJune 9, 2006
Last NPPES UpdateFebruary 9, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 9, 2023
✔ NPI 1003857079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in MA · 113177✔ Licensed in IL · 149023194
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1720 N LA SALLE DR APT 22, Chicago, IL 60614
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Secondary Practice Location 1

Location 11440 Renaissance Dr Ste 320Park Ridge, IL 60068-1471 · Phone (847) 759-9100 ext. 104 · Fax (224) 985-2119

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mary E Ticknor Lcsw, Licsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8426073065
PECOS Enrollment IDI20241108000688
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60614 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $60.08 – $183.39
Typical copayment $0.00 (range $15.02 – $45.84)
Most-billed visit code NA
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Ticknor's NPI number?

The NPI number for Mary Ticknor is 1003857079. It was assigned to this individual provider in the NPPES registry on June 9, 2006.

Where is Mary Ticknor located?

Mary Ticknor practices at 1720 N La Salle Dr Apt 22, Chicago, IL 60614. The listed phone number is (413) 374-6135.

What is Mary Ticknor's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Mary Ticknor enrolled in Medicare?

Yes. Mary Ticknor is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mary Ticknor accept?

Health plans from Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care and Providence Health Plan list Mary Ticknor as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Ticknor was last updated on February 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.