Kylanne Briggs, LCSW

Individual provider Active NPI Clinical Social Worker · Pekin, IL

NPI 1114463569 · NPPES record last updated May 4, 2017

Key facts

NPI
1114463569
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149.019346 (IL)
Practice address
804 Sheridan Rd
Pekin, IL 61554-1629
Phone
(309) 863-5454
NPI assigned
Jan 10, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
149.019346ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.019346 IL Yes

Addresses

Primary practice location

804 Sheridan Rd
Pekin, IL 61554-1629

Mailing address

804 Sheridan Rd
Pekin, IL 61554-1629
Phone (309) 863-5454

Other providers in Pekin, IL

All providers in Pekin, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.