Individual provider Active NPI

Starlene Kelley, LCSW, CADC

  • Clinical Social Worker
  • Warrenville, IL
National Provider Identifier
1487959847
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149014766 Issued in IL
Practice address
4320 Winfield Rd Ste 200
Warrenville, IL 60555-4023
Phone
(312) 801-5100
NPI assigned
Jan 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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 149014766 IL Primary

Addresses

Primary practice location

4320 Winfield Rd Ste 200
Warrenville, IL 60555-4023

Mailing address

4320 Winfield Rd Ste 200
Warrenville, IL 60555-4023
Phone (312) 801-5100

Other names 1

  • Starlene Stewart Former name

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
I20110809000148 IL Practitioner - Clinical Social Worker 5597934588 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4320 Winfield Rd
Suite 200
Warrenville, IL 60555-4023
Phone (312) 801-5100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149014766ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Resonate & Elevate LLC Clinical CurrentSince Jun 1, 2019 Accepting new patients
Samaritan Counseling Center PastSince Jul 2, 2012 Accepting new patients

Locations

4320 Winfield Rd
Ste 200
Warrenville, IL 60555
Phone (630) 410-9587

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1295222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1487959847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 WINFIELD RD STE 200",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554023",
            "telephone_number": "312-801-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 WINFIELD RD STE 200",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554023",
            "telephone_number": "312-801-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "STARLENE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-17",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STARLENE",
            "last_name": "STEWART",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warrenville, IL

Sources for this page

Verify at the official NPI Registry.