Individual provider Active NPI

Michelle Rose Krepps, MSW LCSW

  • Clinical Social Worker
  • Homer Glen, IL
National Provider Identifier
1477713980
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149012874 Issued in IL
Practice address
12627 W 143Rd St
Homer Glen, IL 60491-8381
Phone
(708) 645-0798
NPI assigned
Jun 10, 2008
Last updated
May 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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 149012874 IL Primary

Addresses

Primary practice location

12627 W 143Rd St
Homer Glen, IL 60491-8381

Mailing address

12627 W 143Rd St
Homer Glen, IL 60491-8381
Phone (708) 590-6833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20080712000107 IL Practitioner - Clinical Social Worker 9234201997 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Christian Counseling Center Inc Clinical PastSince Feb 1, 2010 Accepting new patients
Clinical Associates in Counseling, LLC Past Accepting new patients

Organizations & group practices 3

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": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1477713980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12627 W 143RD ST",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918381",
            "telephone_number": "708-590-6833",
            "fax_number": "708-590-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12627 W 143RD ST",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918381",
            "telephone_number": "708-645-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREPPS",
        "first_name": "MICHELLE",
        "middle_name": "ROSE",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

Verify at the official NPI Registry.