Active NPI
Kelly Richter
- Social Worker
- Bourbonnais, IL
National Provider Identifier
1508315557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150,101968
- Practice address
- 581 William Latham Dr
Bourbonnais, IL 60914-2317 - Phone
- (815) 932-3823
- NPI assigned
- Sep 30, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150,101968 | IL | Primary |
Addresses
Primary practice location
581 William Latham Dr
Bourbonnais, IL 60914-2317
Mailing address
16027 Oak Ave
Oak Forest, IL 60452-4028
Phone (815) 932-3823
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150,101968 | IL | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindful Healing Counseling Center, P.C. | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Counselor
- Oak Forest, IL
- NPI 1144935834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590710400000",
"number": "1508315557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16027 OAK AVE",
"city": "OAK FOREST",
"state": "IL",
"postal_code": "604524028",
"telephone_number": "815-932-3823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "581 WILLIAM LATHAM DR",
"city": "BOURBONNAIS",
"state": "IL",
"postal_code": "609142317",
"telephone_number": "815-932-3823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHTER",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-30",
"last_updated": "2020-05-29",
"certification_date": "2020-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150,101968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bourbonnais, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.