Kelly Nolen, LCSW, TYPE 73

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149010474 Issued in IL

Practice address

132 E 79TH St
Chicago, IL 60619-2302

Phone

(773) 487-0515

NPI assigned

Jan 3, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Gilead Behavioral Health Services Inc

  • Pastoral Counselor
  • Chicago, IL
  • NPI 1093728867
  NPD (past)

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

{
    "created_epoch": "1262476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262476800000",
    "number": "1427388115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6521 BRIDLE PATH DR",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433343",
            "telephone_number": "708-833-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E 79TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606192302",
            "telephone_number": "773-487-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLEN",
        "first_name": "KELLY",
        "credential": "LCSW, TYPE 73",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-03",
        "last_updated": "2010-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Elizabeth Nolan, MOT, OTR/L
• Rachel Diane Nolan
• Kara Eileen Noland
• Greta Ayn Nold, OTR/L
• Mark T Nolden, M.D.
• Rachel Ann Noll, LSW
• Nomad Rehab LLC
• Neelofar Nomani, PHARM.D
• Nomura Counseling & Consulting, LLC
• Mio Nomura, 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 Jan 3, 2010; 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.