Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary E Ticknor, LCSW, LICSW

Individual provider Clinical Social Worker · NPI 1003857079

Mary E Ticknor, LCSW, LICSW is a Clinical Social Worker in Chicago, Illinois. Qualified in 2002, 24 years ago. Practices as a sole proprietor, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Illinois and Massachusetts.

Years since qualifying
24
Licensed in
IL, MA
In the registry since
2006
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

1720 N La Salle Dr Apt 22
Chicago, IL 60614-5845
Phone: (413) 374-6135
Fax: (888) 335-8179
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1440 Renaissance Dr Ste 320, Park Ridge, IL 60068-1471 — (847) 759-9100

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 113177 (MA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 149023194 (IL)

Record details

NPI number1003857079
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW , LICSW
Sole proprietorYes
NPI enumeratedJune 9, 2006
Last updated in NPPESFebruary 9, 2023
Certification dateFebruary 9, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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