Individual provider Active NPI

Taryn M Kerr, LCSW

  • Clinical Social Worker
  • Northbrook, IL
National Provider Identifier
1265953509
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.019494 Issued in IL
Practice address
60 Revere Dr Ste 100
Northbrook, IL 60062-1590
Phone
(773) 739-5599
Fax
(773) 754-8960
NPI assigned
Jun 27, 2017
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 149.019494 IL Primary

Addresses

Primary practice location

60 Revere Dr Ste 100
Northbrook, IL 60062-1590

Mailing address

2500 W Bradley PL Ste 100
Chicago, IL 60618-4716
Phone (773) 649-0766

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.019494ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Taryn K Therapy LLC Current Accepting new patients

Locations

2500 W Bradley Pl
Ste 100
Chicago, IL 60618
Phone (224) 306-1879

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1265953509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W BRADLEY PL STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184716",
            "telephone_number": "773-649-0766",
            "fax_number": "773-754-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 REVERE DR STE 100",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621590",
            "telephone_number": "773-739-5599",
            "fax_number": "773-754-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "TARYN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.