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

Mr. Glen Sekou Fondren, LSW

Individual provider Social Worker · NPI 1275801110

Mr. Glen Sekou Fondren, LSW is a Clinical Social Worker in Melrose Park, Illinois. Qualified in 2020, 6 years ago. Licensed in Illinois.

Years since qualifying
6
Licensed in
IL
In the registry since
2011
What do these letters mean?
LSW — Licensed Social Worker
A state-licensed social worker.

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Practice location Address checks out

1414 Main St
Melrose Park, IL 60160-3902
Phone: (708) 681-0073
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 104100000X (IL)

Record details

NPI number1275801110
Entity typeIndividual (Type 1)
GenderMale
Credentials LSW
Sole proprietorNo
NPI enumeratedDecember 7, 2011
Last updated in NPPESSeptember 17, 2024
Certification dateSeptember 17, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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