Kelsie A. Tobias, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149019608 Issued in IL

Practice address

600 N Main St
Taylorville, IL 62568-1668

Phone

(217) 528-7541

Fax

(217) 824-2114

NPI assigned

Aug 30, 2017

Last updated

May 19, 2020By 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

• Kelsie A. Coonrod Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 7, 2023 through Nov 7, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Springfield Psychological Center, LLC

  • Clinical Psychologist
  • Springfield, IL
  • NPI 1174749881
  NPD (past)

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1255859260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541",
            "fax_number": "217-824-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N MAIN ST",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625681668",
            "telephone_number": "217-528-7541",
            "fax_number": "217-824-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIAS",
        "first_name": "KELSIE",
        "middle_name": "A.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelsiecoonrod@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1025 S 6th St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627032403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELSIE",
            "last_name": "COONROD",
            "middle_name": "A.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taylorville Skilled Nursing & Rehab LLC
• Taylorville Skilled Nursing & Rehab LLC
• Taylorville Vision Center, LTD
• Peggy Tell, LCPC
• Gina Berg Thompson, RPH
• Billie J Toland, FNP-BC
• Toofan Medical Holdings, LTD (Taylorville Urgent Care)
• Toofan Medical Holdings, LTD.
• Kimberly Virginia Turner, FNP-BC
• Karen J Vatthauer, LCPC, BCPC

• Clinical Social Worker in Taylorville, IL
• Providers in Taylorville, 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 May 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.