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

Ty Wakefield, LCSW

Individual provider Counselor · NPI 1386005338

Ty Wakefield, LCSW is a Clinical Social Worker in Aurora, Illinois. Qualified in 2016, 10 years ago. Practices with Genesis Health System, a 220-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
10
Licensed in
IL
In the registry since
2016
Specialties on file
6
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

75 Executive Dr Ste 315D
Aurora, IL 60504-8142
Phone: (630) 949-3138
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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 149.019991 (IL)
Counselor Taxonomy 101Y00000X
Mental Health Counselor Taxonomy 101YM0800X
Case Manager/Care Coordinator Taxonomy 171M00000X
Community Health Worker Taxonomy 172V00000X
Health Educator Taxonomy 174H00000X

Record details

NPI number1386005338
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMarch 17, 2016
Last updated in NPPESApril 15, 2024
Certification dateApril 15, 2024
Mailing address1605 2nd Ave, Rock Island, IL 61201-8601

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Genesis Health System — 220 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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