Individual provider Active NPI

Taylor Kiener, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1104589100
Registry record updated Jul 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149027383 Issued in IL
Practice address
3238 N Monticello Ave FL 1
Chicago, IL 60618-5321
Phone
(630) 207-0805
NPI assigned
Oct 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.105387 IL
Clinical Social Worker 1041C0700X 149027383 IL Primary

Addresses

Primary practice location

3238 N Monticello Ave FL 1
Chicago, IL 60618-5321

Mailing address

3238 N Monticello Ave FL 1
Chicago, IL 60618-5321
Phone (630) 207-0805

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
I20240725001166 IL Practitioner - Clinical Social Worker 9830635937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

1 E Erie St
Suite 520
Chicago, IL 60611-2792
Phone (888) 428-7890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150.105387ILMDSocial Worker
149027383ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Guided Mind LLC Clinical CurrentSince Nov 10, 2024 Accepting new patients
Edgewood Clinical Services, P.C. Clinical CurrentSince Jun 12, 2024 Accepting new patients
Psychology Specialists LTD Clinical Past Accepting new patients

Locations

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

1 E Erie St
Ste 520
Chicago, IL 60611
Phone (312) 761-4726

3027 English Rows Ave
Ste 201
Naperville, IL 60564

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

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": "1634342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720915200000",
    "number": "1104589100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3238 N MONTICELLO AVE FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185321",
            "telephone_number": "630-207-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3238 N MONTICELLO AVE FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185321",
            "telephone_number": "630-207-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIENER",
        "first_name": "TAYLOR",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-16",
        "last_updated": "2024-07-14",
        "certification_date": "2024-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.105387",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.