Individual provider Active NPI

Kelly Finch, LCSW

  • Clinical Social Worker
  • Rockford, IL
National Provider Identifier
1013020635
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149008958 Issued in IL
Practice address
4320 Spring Creek Rd
Ste 19
Rockford, IL 61107-1158
Phone
(815) 222-9485
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149008958 IL Primary

Addresses

Primary practice location

4320 Spring Creek Rd
Ste 19
Rockford, IL 61107-1158

Mailing address

4320 Spring Creek Rd
Ste 19
Rockford, IL 61107-1158
Phone (815) 222-9485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050110000162 IL Practitioner - Clinical Social Worker 5597713230 Reassigns benefits to 1 organization
Practice locations: Rockford, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Counseling Services of Northern IllinoisGroup PAC ID 0244305936, 2 clinicians

Practice addresses (Care Compare)

4320 Spring Creek Rd
Suite 19
Rockford, IL 61107-1158
Phone (815) 222-9485

631 N Longwood St
Suite 103
Rockford, IL 61107-4263
Phone (815) 962-5585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149008958ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carey Counseling Past Accepting new patients
Rockford Psychiatric Medical Services, S.C. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1013020635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 SPRING CREEK RD",
            "address_2": "STE 19",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071158",
            "telephone_number": "815-222-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 SPRING CREEK RD",
            "address_2": "STE 19",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071158",
            "telephone_number": "815-222-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINCH",
        "first_name": "KELLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149008958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.