Individual provider Active NPI

Kelly Ann Kalt, MSW, LCSW

  • Clinical Social Worker
  • Rockford, IL
National Provider Identifier
1063513513
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.010705 Issued in IL
Practice address
1639 N Alpine Rd Ste 403
Rockford, IL 61107-1440
Phone
(815) 229-7102
Fax
(815) 229-7108
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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 149.010705 IL Primary

Addresses

Primary practice location

1639 N Alpine Rd Ste 403
Rockford, IL 61107-1440

Mailing address

1639 N Alpine Rd Ste 403
Rockford, IL 61107-1440
Phone (815) 229-7102

Other identifiers 6

IdentifierTypeStateIssuer
506515OtherVALUEOPTIONS
7233792OtherAETNA
IL1715OtherMEDICARE PTAN
830010000OtherILMAGELLAN
0010132116OtherBC/BS ID
2158705OtherCOMPSYCH

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
I20070214000277 IL Practitioner - Clinical Social Worker 0941202345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1639 N Alpine Rd
Suite 403
Rockford, IL 61107-1440
Phone (815) 229-7102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.010705ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly a. Kalt, MSW, LCSW, Inc. Clinical CurrentSince Dec 7, 2010 Accepting new patients
Laura L Allman LCSW LTD Clinical PastSince Sep 26, 2014 Accepting new patients

Locations

1639 N Alpine Rd
Ste 403
Rockford, IL 61107
Phone (608) 492-1992

Organizations & group practices 2

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1063513513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1639 N ALPINE RD STE 403",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071440",
            "telephone_number": "815-229-7102",
            "fax_number": "815-229-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 N ALPINE RD STE 403",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071440",
            "telephone_number": "815-229-7102",
            "fax_number": "815-229-7108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALT",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.010705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS",
            "identifier": "506515",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7233792",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL1715",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "830010000",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS ID",
            "identifier": "0010132116",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "2158705",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.