Individual provider Active NPI

Keri Beth Powell, LCSW

  • Clinical Social Worker
  • Champaign, IL
National Provider Identifier
1154587525
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-013139 Issued in IL
Practice address
2125 S Neil St
Champaign, IL 61820-7266
Phone
(217) 352-0200
Fax
(217) 607-1139
NPI assigned
Aug 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 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 149-013139 IL Primary

Addresses

Primary practice location

2125 S Neil St
Champaign, IL 61820-7266

Mailing address

2125 S Neil St
Champaign, IL 61820-7266
Phone (217) 352-0200

Other practice location 1

116 S Lombard St
Mahomet, IL 61853-9202
Phone (217) 352-0200

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
I20090529000135 IL Practitioner - Clinical Social Worker 8729137492 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-013139ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Keri Powell Therapy Inc Clinical CurrentSince Jan 2, 2012 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2125 S Neil St
Champaign, IL 61820
Phone (217) 356-3736

701 Devonshire Dr
Ste B1
Champaign, IL 61820
Phone (217) 778-4134

116 S Lombard St
Mahomet, IL 61853

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": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1154587525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 S NEIL ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207266",
            "telephone_number": "217-352-0200",
            "fax_number": "217-607-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 S NEIL ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207266",
            "telephone_number": "217-352-0200",
            "fax_number": "217-607-1139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 S Lombard St",
            "address_purpose": "LOCATION",
            "city": "Mahomet",
            "state": "IL",
            "postal_code": "618539202",
            "country_code": "US",
            "telephone_number": "217-352-0200",
            "fax_number": "217-607-1139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "KERI",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-013139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.