Kathleen Carey, LCSW
Individual provider Active NPI Clinical Social Worker · Olney, IL
NPI 1245763754 · NPPES record last updated May 10, 2018
Key facts
- NPI
- 1245763754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 149.012203 (IL)
- Practice address
- 421 S Elliott St
Olney, IL 62450-2746 - Phone
- (618) 839-4575
- NPI assigned
- Apr 11, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ultacare Medical PLLC
Practice addresses (Care Compare)
410 E Mack Ave
Olney, IL 62450-2319
Phone (710) 658-6338
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180119000820 | IL | Practitioner - Clinical Social Worker | 3072872035 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.012203 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ultacare Medical PLLC | Clinical | Current |
Accepting new patients |
Locations
7951 E Maplewood Ave
Ste 118
Greenwood Village, CO 80111
40 N 64th St
Belleville, IL 62223
Phone (618) 397-8400
210 E College St
Energy, IL 62933
Phone (618) 942-7014
900 E Scott St
Olney, IL 62450
Phone (618) 345-1000
410 E Mack Ave
Olney, IL 62450
Phone (618) 395-7421
5261 Carrollton Pike
Ste A
Woodlawn, VA 24381
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.012203 | IL | Yes |
Addresses
Primary practice location
421 S Elliott St
Olney, IL 62450-2746
Mailing address
421 S Elliott St
Olney, IL 62450-2746
Phone (618) 839-4575
Other providers in Olney, IL
- Jamie Leigh Burgener
- Terry Burgener
- Burgin Manor of Olney Inc
- Sandy Burke
- Ashley Bussard
- Kelcy Marie Carlson
- Trenton Clapp
- Paige Breanne Clayton
- Rachel Clow
- Debra K Coad
All providers in Olney, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.