Kathleen Kelly, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

149001308 Issued in IL

Practice address

1401 Lakewood Dr
Suite a
Morris, IL 60450-3352

Phone

(815) 942-6323

Fax

(815) 942-6423

NPI assigned

Jun 7, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1477593796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 LAKEWOOD DR",
            "address_2": "SUITE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604503352",
            "telephone_number": "815-942-6323",
            "fax_number": "815-942-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 LAKEWOOD DR",
            "address_2": "SUITE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604503352",
            "telephone_number": "815-942-6323",
            "fax_number": "815-942-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149001308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan H Kays, OD
• Thomas M Kazmierczak Jr., DO
• Keith W Jaeschke DDS PC
• Keith W. Jaeschke D.D.S., P.C.
• Courtney Ann Kelly, PA-C
• Meghan Kelly
• Kellie Kennedy
• Aftab A Khan, M.D.
• Barbara G Kijek, MD
• Mark A Kijek, MD SC

• Social Worker in Morris, IL
• Providers in Morris, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.