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NICOLE MEDINA LSW
NPI 1063392256
Social Worker in Libertyville, IL

Active since September 06, 2025
1800 HOLLISTER DR STE 201, LIBERTYVILLE, IL 60048(847) 549-1189 Get Directions Write a Review

NPPES record last updated: October 24, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Nicole Medina Lsw NPPES

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

NICOLE MEDINA LSW (NPI 1063392256) is an individual social worker in Libertyville, Illinois, licensed in Illinois (150.116992) and active in the NPI registry since September 2025. She maintains a secondary practice location in Northbrook.

NPPES Registry Identity

NPI1063392256
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameNICOLE MEDINACredential: LSW
Location Address1800 HOLLISTER DR STE 201Libertyville, IL 60048-5266
Mailing Address36163 N James CtIngleside, IL 60041-8210
Phone(847) 549-1189
Sole ProprietorNo
Enumeration DateSeptember 6, 2025
Last NPPES UpdateOctober 24, 2025
NPPES CertifiedSeptember 6, 2025
✔ NPI 1063392256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in IL · 150.116992
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
1800 HOLLISTER DR STE 201, Libertyville, IL 60048
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Secondary Practice Location 1

Location 1604 Academy DrNorthbrook, IL 60062-2421 · Phone (847) 549-1189

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BAILEY LYNN LAMBERT-CANDAZA LCSW
Social Worker (Clinical)
1800 HOLLISTER DR STE 201
LIBERTYVILLE, IL 60048
Lake County (847) 549-1189
ANDREW HAMLYN LCPC
Counselor (Mental Health)
1800 HOLLISTER DR STE 201
LIBERTYVILLE, IL 60048
Lake County (847) 549-1189
IZABELLA SISARICA LCPC
Counselor (Professional)
1800 HOLLISTER DR STE 201
LIBERTYVILLE, IL 60048
Lake County (847) 549-1189
DR. BENJAMIN MICHAELS PSYD
Psychologist (Clinical)
1800 HOLLISTER DR STE 201
LIBERTYVILLE, IL 60048
Lake County (847) 549-1189
LESLIE HERRERA LSW
Social Worker
1800 HOLLISTER DR STE 201
LIBERTYVILLE, IL 60048
Lake County (847) 549-1189
ERIN DANAHY LCSW
Social Worker (Clinical)
1800 HOLLISTER DR STE 201
LIBERTYVILLE, IL 60048
Lake County (847) 404-9366
OLGA PRUTNIKOV MSW, LCSW
Social Worker (Clinical)
1800 HOLLISTER DR STE 201
LIBERTYVILLE, IL 60048
Lake County (847) 549-1189
STACY ANNE KOCH LCSW
Social Worker (Clinical)
1800 HOLLISTER DR STE 201
LIBERTYVILLE, IL 60048
Lake County (847) 549-1189

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 Nicole Medina's NPI number?

The NPI number for Nicole Medina is 1063392256. It was assigned to this individual provider in the NPPES registry on September 6, 2025.

Where is Nicole Medina located?

Nicole Medina practices at 1800 Hollister Dr Ste 201, Libertyville, IL 60048. The listed phone number is (847) 549-1189.

What is Nicole Medina's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

When was this NPI record last updated?

The NPPES record for Nicole Medina was last updated on October 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.