Kelly M. O'Hern, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149014050 Issued in IL

Practice address

210 N Hammes Ave
Suite 103
Joliet, IL 60435-6680

Phone

(815) 942-6323

Fax

(815) 942-6423

NPI assigned

Apr 18, 2007

Last updated

Jan 24, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kelly M Freeman Former name

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

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Counseling and Coaching of Illinois LLCGroup PAC ID 5496093213, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Alliance Counseling & Coaching of Illinois, PLLC

  • Professional Counselor
  • Channahon, IL
  • NPI 1063867257
  Medicare reassignment Care Compare group NPD
• Larc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Lansing, IL
  • NPI 1245695733
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1174749824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 LAKEWOOD DR",
            "address_2": "SUITE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604503352",
            "telephone_number": "815-942-6323",
            "fax_number": "815-942-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N HAMMES AVE",
            "address_2": "SUITE 103",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356680",
            "telephone_number": "815-942-6323",
            "fax_number": "815-942-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HERN",
        "first_name": "KELLY",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "FREEMAN",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• De'Andre Nunn, OTR/L
• Laura Nurczyk
• Chukwuma Chisom Nwachukwu, MD
• Haley Nystrom
• Ryan P O'Boyle, PTA
• Michelle Collier O'Leary, MD
• Lindsay M O'Neal, DPT
• Sean Daniel O'Shaughnessy
• Michelle Erma Obrien, SLP/L
• Oceangreen Inc

• Clinical Social Worker in Joliet, IL
• Providers in Joliet, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.