Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Shannon Nicole Maximov, LCSW

Individual provider Clinical Social Worker · NPI 1245378835

MS. Shannon Nicole Maximov, LCSW is a Clinical Social Worker in Lake Forest, Illinois. Qualified in 2004, 22 years ago. Practices with Northwestern Medical Faculty Foundation, a 4,394-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
22
Licensed in
IL
In the registry since
2007
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

900 N Westmoreland Rd Ste 114
Lake Forest, IL 60045-1680
Phone: (312) 695-7542
Fax: (312) 694-2535
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 149023293 (IL)

Record details

NPI number1245378835
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedFebruary 3, 2007
Last updated in NPPESMarch 31, 2022
Certification dateMarch 31, 2022

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Northwestern Medical Faculty Foundation — 4394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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