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DR. DOMONICQUE TATUM EDD, LCSW
NPI 1629593173
Social Worker - Clinical in Markham, IL

Active since August 06, 2017
16300 KEDZIE AVE, MARKHAM, IL 60428(571) 282-5193 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Aug 6, 2017 (2 updates tracked since 2017).

About Dr. Domonicque Tatum Edd, Lcsw NPPES

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

DR. DOMONICQUE TATUM EDD, LCSW (NPI 1629593173) is an individual clinical provider in Markham, Illinois, licensed in Illinois (149.017448) and active in the NPI registry since August 2017.

NPPES Registry Identity

NPI1629593173
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameDR. DOMONICQUE TATUMCredential: EDD, LCSW
Location Address16300 KEDZIE AVEMarkham, IL 60428-5508
Mailing Address16300 Kedzie AveMarkham, IL 60428-5508 · (571) 282-5193
Phone(571) 282-5193
Sole ProprietorYes
Enumeration DateAugust 6, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1629593173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IL · 149.017448
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.
16300 KEDZIE AVE, Markham, IL 60428
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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 Domonicque Tatum's NPI number?

The NPI number for Domonicque Tatum is 1629593173. It was assigned to this individual provider in the NPPES registry on August 6, 2017.

Where is Domonicque Tatum located?

Domonicque Tatum practices at 16300 Kedzie Ave, Markham, IL 60428. The listed phone number is (571) 282-5193.

What is Domonicque Tatum's specialty?

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

When was this NPI record last updated?

The NPPES record for Domonicque Tatum was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.