Individual provider Active NPI

Kristin Pasley, LCSW

  • Clinical Social Worker
  • Champaign, IL
National Provider Identifier
1174288369
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.023931 Issued in IL
Practice address
2125 S Neil St
Champaign, IL 61820-7266
Phone
(217) 352-0200
Fax
(217) 607-1139
NPI assigned
Nov 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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 149.023931 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

1415 W 22nd St
Oak Brook, IL 60523-2074
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
I20211117001970 IL Practitioner - Clinical Social Worker 2769871581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keri Powell Therapy IncGroup PAC ID 9638335532, 36 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.023931ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Keri Powell Therapy Inc Clinical CurrentSince Nov 10, 2021 Accepting new patients

Locations

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

208 S Market St
Monticello, IL 61856

1415 W 22nd St
Oak Brook, IL 60523
Phone (312) 806-3800

7 Dunlap Ct
Savoy, IL 61874
Phone (217) 203-2008

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": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1174288369",
    "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": "1415 W 22nd St",
            "address_purpose": "LOCATION",
            "city": "Oak Brook",
            "state": "IL",
            "postal_code": "605232074",
            "country_code": "US",
            "telephone_number": "217-352-0200",
            "fax_number": "217-607-1139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASLEY",
        "first_name": "KRISTIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.023931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.