Individual provider Active NPI

Kaley Anne Witowski, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1154993038
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149023426 Issued in IL
Practice address
644 W Webster Ave Unit B
Chicago, IL 60614-3710
Phone
(773) 991-3016
NPI assigned
Jul 12, 2021
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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 149023426 IL Primary

Addresses

Primary practice location

644 W Webster Ave Unit B
Chicago, IL 60614-3710

Mailing address

644 W Webster Ave Unit B
Chicago, IL 60614-3710
Phone (773) 991-3016

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
149023426ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Park Psychology, Inc. CurrentSince Jul 20, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1154993038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 W WEBSTER AVE UNIT B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143710",
            "telephone_number": "773-991-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 W WEBSTER AVE UNIT B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143710",
            "telephone_number": "773-991-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITOWSKI",
        "first_name": "KALEY",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149023426",
            "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 Jul 12, 2021; 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.