Active NPI
Kristen Angela Melchiori, MSW, CADC
- Clinical Social Worker
- Dekalb, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.021903
- Practice address
- 631 S 1St St
Dekalb, IL 60115-4117 - Phone
- (815) 756-8501
- Fax
- (815) 756-5849
- NPI assigned
- Aug 2, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | 149.021903 | IL | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 31825 | IL |
Addresses
Primary practice location
631 S 1St St
Dekalb, IL 60115-4117
Mailing address
631 S 1St St
Dekalb, IL 60115-4117
Phone (815) 756-8501
Other names 1
- Kristen Angela Porzel
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
900 E Diehl Rd
Suite 101
Naperville, IL 60563-2394
Phone (888) 428-7890
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31825 | IL | MD | Addiction (Substance Use Disorder) Counselor |
| 149.021903 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edgewood Clinical Services, P.C. | Mental Health | Current | Accepting new patients |
| Psychology Specialists LTD | Clinical | Past | Accepting new patients |
Locations
808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007
2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165
900 E Diehl Rd
Ste 101
Naperville, IL 60563
Phone (630) 328-0134
Organizations & group practices 2
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.
-
- Clinical Psychologist
- Bloomington, IL
- NPI 1053368605
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730505600000",
"number": "1295259059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "631 S 1ST ST",
"city": "DEKALB",
"state": "IL",
"postal_code": "601154117",
"telephone_number": "815-756-8501",
"fax_number": "815-756-5849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 S 1ST ST",
"city": "DEKALB",
"state": "IL",
"postal_code": "601154117",
"telephone_number": "815-756-8501",
"fax_number": "815-756-5849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELCHIORI",
"first_name": "KRISTEN",
"middle_name": "ANGELA",
"credential": "MSW, CADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-02",
"last_updated": "2024-11-02",
"certification_date": "2024-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.021903",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IL",
"license": "31825",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTEN",
"last_name": "PORZEL",
"middle_name": "ANGELA",
"credential": "CADC",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Dekalb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2024; 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.