Individual provider Active NPI

Quincey F Kyles, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1154550333
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015349 Issued in IL
Practice address
2650 W Montrose Ave Ste 205
Chicago, IL 60618-1674
Phone
(404) 543-5654
Fax
(312) 275-7564
NPI assigned
Jul 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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 149015349 IL Primary

Addresses

Primary practice location

2650 W Montrose Ave Ste 205
Chicago, IL 60618-1674

Mailing address

2650 W Montrose Ave Ste 205
Chicago, IL 60618-1674
Phone (404) 543-5654

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149015349ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Quincey F. Kyles Counseling Services, LLC. CurrentSince Aug 23, 2020 Accepting new patients

Locations

2650 W Montrose Ave
Ste 205
Chicago, IL 60618
Phone (404) 543-5654

Organizations & group practices 1

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": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1154550333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 W MONTROSE AVE STE 205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181674",
            "telephone_number": "404-543-5654",
            "fax_number": "312-275-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 W MONTROSE AVE STE 205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181674",
            "telephone_number": "404-543-5654",
            "fax_number": "312-275-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLES",
        "first_name": "QUINCEY",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-08",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.