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MR. GLEN SEKOU FONDREN LSW
NPI 1275801110
Social Worker in Melrose Park, IL

Active since December 07, 2011PECOS Enrolled
1414 MAIN ST, MELROSE PARK, IL 60160(708) 681-0073 Get Directions Write a Review

NPPES record last updated: September 17, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mr. Glen Sekou Fondren Lsw NPPES

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

MR. GLEN SEKOU FONDREN LSW (NPI 1275801110) is an individual social worker in Melrose Park, Illinois, licensed in Illinois (104100000X) and active in the NPI registry since December 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275801110
Entity TypeIndividualMale
Primary Taxonomy104100000X
Provider Legal NameMR. GLEN SEKOU FONDRENCredential: LSW
Location Address1414 MAIN STMelrose Park, IL 60160-3902
Mailing Address1414 Main StMelrose Park, IL 60160-3902 · (708) 681-0073
Phone(708) 681-0073
Sole ProprietorNo
Enumeration DateDecember 7, 2011
Last NPPES UpdateSeptember 17, 2024
NPPES CertifiedSeptember 17, 2024
✔ NPI 1275801110 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 · 104100000X
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.
1414 MAIN ST, Melrose Park, IL 60160
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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)

Mr. Glen Sekou Fondren Lsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Glen Fondren reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Presence Behavioral Health
Same address
Mental Health (Including Community Mental Health Center)
1414 MAIN ST
Melrose Park, IL 60160
  • Reassigned Medicare billing, Illinois enrollment
  • 11 clinicians in this Medicare group
NPI 1477622298 (708) 681-2324

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

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.

MR. JASON PETER SCHALLACK MFA
Counselor (Mental Health)
1414 MAIN ST
MELROSE PARK, IL 60160
Cook County (708) 681-0073
ZOEY WARD BRYSON BA
Counselor (Mental Health)
1414 MAIN ST
MELROSE PARK, IL 60160
Cook County (708) 681-0073
RICHARD O SODEINDE
Counselor
1414 MAIN ST
MELROSE PARK, IL 60160
Cook County (708) 681-0073
PRESENCE BEHAVIORAL HEALTH PROCARE CENTERS
Community/Behavioral Health
1414 MAIN ST
MELROSE PARK, IL 60160
Cook County (708) 786-8501
JOANNA GIORDANO MA, LPC, QMHP
Counselor (Professional)
1414 MAIN ST
MELROSE PARK, IL 60160
Cook County (708) 681-0073
JACQUELINE OROZCO
Behavior Technician
1414 MAIN ST
MELROSE PARK, IL 60160
Cook County (708) 704-4523
MICHELLE LAGRIMAS B.A.
Counselor (Mental Health)
1414 MAIN ST
MELROSE PARK, IL 60160
Cook County (708) 681-4357
DOUGLAS WILLIAM BARGE
Counselor (Mental Health)
1414 MAIN ST
MELROSE PARK, IL 60160
Cook County (708) 786-8546

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 Glen Fondren's NPI number?

The NPI number for Glen Fondren is 1275801110. It was assigned to this individual provider in the NPPES registry on December 7, 2011.

Where is Glen Fondren located?

Glen Fondren practices at 1414 Main St, Melrose Park, IL 60160. The listed phone number is (708) 681-0073.

What is Glen Fondren's specialty?

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

Is Glen Fondren enrolled in Medicare?

Yes. Glen Fondren is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Glen Fondren's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Glen Fondren reassigns Medicare benefits to Presence Behavioral Health (Melrose Park, 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 Glen Fondren'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 Glen Fondren was last updated on September 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.