Individual provider Active NPI

Katie Marie Kroening, LCSW

  • Clinical Social Worker
  • Crystal Lake, IL
National Provider Identifier
1548718844
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.016805 Issued in IL
Practice address
475 W Terra Cotta Ave Ste E
Crystal Lake, IL 60014-3407
Phone
(815) 707-4806
Fax
(815) 977-8715
NPI assigned
Sep 14, 2016
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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 149.016805 IL Primary

Addresses

Primary practice location

475 W Terra Cotta Ave Ste E
Crystal Lake, IL 60014-3407

Mailing address

3501 S Cherry Valley Rd
Woodstock, IL 60098-8142
Phone (847) 809-8494

Other practice location 1

1005 Alexander Ct Ste E
Cary, IL 60013-1891
Phone (815) 707-4806 ext. 21

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
I20191218001276 IL Practitioner - Clinical Social Worker 9931533379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 2011
Medicare assignment
May accept Medicare assignment
Group practices
The Center for Courageous Living LLCGroup PAC ID 7113350612, 6 clinicians

Practice addresses (Care Compare)

377 W Virginia St
Crystal Lake, IL 60014-5756
Phone (815) 707-4806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.016805ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Courageous Living LLC Clinical CurrentSince Nov 15, 2019 Accepting new patients
The Center for Courageous Living LLC Clinical Past Accepting new patients
The Center for Courageous Living LLC Past Accepting new patients

Locations

125 S Virginia St
Crystal Lake, IL 60014
Phone (815) 707-4806

377 W Virginia St
Crystal Lake, IL 60014
Phone (815) 707-4806

475 W Terra Cotta Ave
Ste E
Crystal Lake, IL 60014
Phone (815) 707-4806

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": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1548718844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 S CHERRY VALLEY RD",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600988142",
            "telephone_number": "847-809-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 W TERRA COTTA AVE STE E",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143407",
            "telephone_number": "815-707-4806",
            "fax_number": "815-977-8715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Alexander Ct Ste E",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "IL",
            "postal_code": "600131891",
            "country_code": "US",
            "telephone_number": "815-707-4806 x21",
            "fax_number": "815-977-8715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KROENING",
        "first_name": "KATIE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.