Kelly Eileen Crooks, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149-019093 Issued in IL

Practice address

2049 S Walnut St # T
Springfield, IL 62704-4527

Phone

(618) 975-4598

NPI assigned

May 29, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Board of Trustees of Southern Illinois University

  dba Siu Center for Family Medicine

  • Primary Care Clinic/Center
  • Springfield, IL
  • NPI 1396097960
  NPD
• Bootheel Counseling Services

  • Community/Behavioral Health Agency
  • Sikeston, MO
  • NPI 1700652898
  NPD (past)

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1073925723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2049 S WALNUT ST # T",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044527",
            "telephone_number": "618-975-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2049 S WALNUT ST # T",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044527",
            "telephone_number": "618-975-4598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 3rd St",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "IL",
            "postal_code": "62656",
            "country_code": "US",
            "telephone_number": "217-735-2317",
            "fax_number": "217-732-6943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROOKS",
        "first_name": "KELLY",
        "middle_name": "EILEEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-019093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Latoya Crite
• Abigail M Crocker
• Torin Crockett
• Brook D Croke, M.S., C.G.C.
• Seth Cronin, PT
• Dana Lynn Crosby, MD
• James David Cross, D.D.S.
• Amy J Crossett, RN
• Mackenzie Lynn Crossland, RBT
• Mark A Crossland, B.S. RPH

• Clinical Social Worker in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.