Individual provider Active NPI

Kellee J Ward, LCSW

  • Clinical Social Worker
  • Bourbonnais, IL
National Provider Identifier
1174117956
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.030731 Issued in IL
Practice address
755 Almar Pkwy Ste a
Bourbonnais, IL 60914-2393
Phone
(630) 428-7890
NPI assigned
Feb 23, 2021
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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 NU
Clinical Social Worker 1041C0700X 149.030731 IL Primary

Addresses

Primary practice location

755 Almar Pkwy Ste a
Bourbonnais, IL 60914-2393

Mailing address

755 Almar Pkwy Ste a
Bourbonnais, IL 60914-2393

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
149.030731ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1174117956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 ALMAR PKWY STE A",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 ALMAR PKWY STE A",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142393",
            "telephone_number": "630-428-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "KELLEE",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.030731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; 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.