Individual provider Active NPI

Kirsten M Edwards, LCSW

  • Clinical Social Worker
  • Hoffman Estates, IL
National Provider Identifier
1184947442
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013572 Issued in IL
Practice address
2500 W Higgins Rd Ste 1133
Hoffman Estates, IL 60169-7239
Phone
(847) 805-8800
NPI assigned
Mar 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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 149.013572 IL Primary

Addresses

Primary practice location

2500 W Higgins Rd Ste 1133
Hoffman Estates, IL 60169-7239

Mailing address

2500 W Higgins Rd Ste 1133
Hoffman Estates, IL 60169-7239
Phone (847) 805-8800

Other names 1

  • Miss Kirsten M Johnson Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.013572ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rooted Hope Counseling, PLLC Clinical CurrentSince Sep 20, 2022 Accepting new patients

Locations

2500 W Higgins Rd
Ste 1133
Hoffman Estates, IL 60169
Phone (630) 825-5548

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": "1267401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1184947442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W HIGGINS RD STE 1133",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601697239",
            "telephone_number": "847-805-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W HIGGINS RD STE 1133",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601697239",
            "telephone_number": "847-805-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KIRSTEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-01",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "JOHNSON",
            "middle_name": "M",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hoffman Estates, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.