TY WAKEFIELD (LCSW) – Clinical Social Worker, NPI 1386005338
Clinical Social Worker
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
3,557 CLINICAL SOCIAL WORKER in IL
Provider Addresses for TY WAKEFIELD (LCSW)
2316, 5th Avenue, Moline, Rock Island County, Illinois, 61265, United States
MOLINE, IL 612651530
Phone: (309) 762-5433
Type: Mailing
4600 3RD ST
MOLINE, IL 612656106
Phone: (309) 779-3000
Type: Mailing
5401 44TH AVENUE DR
MOLINE, IL 612658128
Phone: (309) 779-4061
Type: Location
1605 2ND AVE
ROCK ISLAND, IL 612018601
Phone:
Type: Mailing
75 EXECUTIVE DR STE 315D
AURORA, IL 605048142
Phone: (630) 949-3138
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-03-26
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180326002122 | I | Clinical Social Worker | IA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90834 | Psychotherapy, 45 minutes | 50 | 16 | $0 |
Insurance plans in this area (ZIP 61265)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IA | |
| - | IA | |
| Nurse Practitioner | IA | |
| P S Y C H I A T R Y | IA | |
| - | IA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| Family Practice | IA | |
| - | IA | |
| - | IA | |
| Clinical Social Worker | IA |
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