Individual provider Active NPI

Morgan Kellen, LCSW

  • Clinical Social Worker
  • Lake Zurich, IL
National Provider Identifier
1306612692
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
258594 Issued in KY
Practice address
25397 N Northbridge Rd
Lake Zurich, IL 60047-7359
Phone
(847) 732-6603
NPI assigned
Nov 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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 258594 KY Primary

Addresses

Primary practice location

25397 N Northbridge Rd
Lake Zurich, IL 60047-7359

Mailing address

25397 N Northbridge Rd
Lake Zurich, IL 60047-7359
Phone (847) 732-6603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231221001593 KY Practitioner - Clinical Social Worker 7012367758 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Astra Behavioral Health LLC CurrentSince Dec 7, 2023 Accepting new patients

Locations

1013 Granite Dr
Bardstown, KY 40004
Phone (270) 506-2730

2000 Ring Rd
Elizabethtown, KY 42701
Phone (270) 506-2730

4010 DuPont Cir
Ste 210
Louisville, KY 40207
Phone (502) 694-4820

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": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1306612692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25397 N NORTHBRIDGE RD",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600477359",
            "telephone_number": "847-732-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25397 N NORTHBRIDGE RD",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600477359",
            "telephone_number": "847-732-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEN",
        "first_name": "MORGAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "258594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Zurich, IL

Sources for this page

Verify at the official NPI Registry.