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BETHANY JUDSON LCSW
NPI 1124884754
Social Worker - Clinical in Chicago, IL

Active since February 21, 2024PECOS Enrolled
4009 N BROADWAY ST, CHICAGO, IL 60613(773) 275-2586 Get Directions Write a Review

NPPES record last updated: January 29, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Bethany Judson Lcsw NPPES

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

BETHANY JUDSON LCSW (NPI 1124884754) is an individual clinical provider in Chicago, Illinois, licensed in Illinois (149.028744) and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1124884754
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameBETHANY JUDSONCredential: LCSW
Location Address4009 N BROADWAY STChicago, IL 60613-2110
Mailing Address4009 N Broadway StChicago, IL 60613-2110
Phone(773) 275-2586
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateFebruary 21, 2024
Last NPPES UpdateJanuary 29, 2025
NPPES CertifiedJanuary 29, 2025
✔ NPI 1124884754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IL · 149.028744
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.
Also ListedSocial WorkerTaxonomy 104100000X · License 150.108996 (IL)
4009 N BROADWAY ST, Chicago, IL 60613
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bethany Judson Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7810425469
PECOS Enrollment IDI20250109002126
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.

Medicare Billing Reassignment

Medicare enrollment records show Bethany Judson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Heartland Alliance Health
Same address
Federally Qualified Health Center (FQHC)
4009 N BROADWAY ST
Chicago, IL 60613
  • Reassigned Medicare billing, Illinois enrollment
  • 7 clinicians in this Medicare group
NPI 1538294483 (773) 275-2586

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60613 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.

Other Providers at the Same Location NPPES 20

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

AISHA AYO WESLEY PA-C
Physician Assistant (Medical)
4009 N BROADWAY ST
CHICAGO, IL 60613
Cook County (773) 275-2586
RONALD ANTHONY HICKOMBOTTOM M.D
Internal Medicine
4009 N BROADWAY ST
CHICAGO, IL 60613
Cook County (773) 275-2586
MICHAEL COLTON DEMPSEY MD
Psychiatry & Neurology (Psychiatry)
4009 N BROADWAY ST
CHICAGO, IL 60613
Cook County (773) 275-2586
VERONIKA R SPEEDWELL PA
Physician Assistant
4009 N BROADWAY ST
CHICAGO, IL 60613
Cook County (773) 275-2586
DR. CHRISTOPHER A. MCCAFFREY-BOSS D.D.S.
Dentist (General Practice)
4009 N BROADWAY ST
CHICAGO, IL 60613
Cook County (773) 275-2586
OLATOKUNBO ADEGBORO MD
Family Medicine
4009 N BROADWAY ST
CHICAGO, IL 60613
Cook County (773) 388-1600
CASSANDRA ANN SMITH DO
Family Medicine
4009 N BROADWAY ST
CHICAGO, IL 60613
Cook County (773) 275-2586
HANNAH PAUL PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
4009 N BROADWAY ST
CHICAGO, IL 60613
Cook County (773) 275-2586

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 Bethany Judson's NPI number?

The NPI number for Bethany Judson is 1124884754. It was assigned to this individual provider in the NPPES registry on February 21, 2024.

Where is Bethany Judson located?

Bethany Judson practices at 4009 N Broadway St, Chicago, IL 60613. The listed phone number is (773) 275-2586.

What is Bethany Judson's specialty?

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

Is Bethany Judson enrolled in Medicare?

Yes. Bethany Judson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Bethany Judson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bethany Judson reassigns Medicare benefits to Heartland Alliance Health (Chicago, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bethany Judson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Bethany Judson was last updated on January 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.