Individual provider Active NPI

Kayla Anne Clayton, LCSW, APSW

  • Clinical Social Worker
  • Machesney Park, IL
National Provider Identifier
1386159747
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.016769 Issued in IL
Practice address
9853 N Alpine Rd # 202
Machesney Park, IL 61115-1681
Phone
(815) 708-7411
NPI assigned
Dec 7, 2017
Last updated
Nov 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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 149.016769 IL Primary

Addresses

Primary practice location

9853 N Alpine Rd # 202
Machesney Park, IL 61115-1681

Mailing address

5062 Rockrose CT Ste 78
Roscoe, IL 61073-7797
Phone (815) 708-7411

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180215002284 IL Practitioner - Clinical Social Worker 6901166735 Reassigns benefits to 1 organization
Practice locations: Roscoe, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Clayton and Clayton Counseling, PLLCGroup PAC ID 0749626588, 2 clinicians

Practice addresses (Care Compare)

Roscoe, IL 61073
Phone (815) 708-7411

8038 Macintosh LN
Rockford, IL 61107-5336
Phone (815) 708-7411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.016769ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clayton & Clayton Counseling, PLLC Clinical CurrentSince Nov 1, 2023 Accepting new patients

Locations

8038 Macintosh Ln
Rockford, IL 61107
Phone (815) 332-6800

5062 Rockrose Ct
Roscoe, IL 61073
Phone (815) 708-7411

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": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1386159747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5062 ROCKROSE CT STE 78",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610737797",
            "telephone_number": "815-708-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9853 N ALPINE RD # 202",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611151681",
            "telephone_number": "815-708-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "KAYLA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, APSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-07",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Machesney Park, IL

Sources for this page

Verify at the official NPI Registry.