Kleah Fernandez, MA, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.026005 Issued in IL

Practice address

5080 N Elston Ave
Chicago, IL 60630-2459

Phone

(773) 541-0403

NPI assigned

Oct 21, 2020

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

• Kleah Danielle Mabalhin Fernandez Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1316546260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 N SHERIDAN RD APT 1203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407301",
            "telephone_number": "773-541-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302459",
            "telephone_number": "773-541-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "KLEAH",
        "credential": "MA, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KLEAH DANIELLE",
            "last_name": "FERNANDEZ",
            "middle_name": "MABALHIN",
            "credential": "MA, LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jose R Fernandez
• Katherine Fernandez, DPT
• Katherine G Fernandez
• Katia Fernandez
• Kimberly Michelle Fernandez, MD
• Krystal Jacqueline Fernandez
• Lizabeth Fernandez
• Louis Fernandez, M.D.
• Manuel Felipe Fernandez, M.D.
• Milagros Fernandez, LCSW

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Oct 31, 2023; 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.