Kathleen A Outzen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149007246 Issued in IL

Practice address

1170 E Riverside Ave
Decatur, IL 62521-3566

Phone

(217) 201-1786

NPI assigned

Mar 18, 2024

Last updated

Mar 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Three Olive Branches Counseling LLC

  • Clinical Social Worker
  • Mt Zion, IL
  • NPI 1790628212
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1578322756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 OXFORD DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625215650",
            "telephone_number": "217-201-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 E RIVERSIDE AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213566",
            "telephone_number": "217-201-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTZEN",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149007246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Obinna Orji, MD
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• Larry William Osborne, D.M.D.
• Dale P Ostrander, MD
• Wael Mohammad Otaibi, D.O.
• Ovations Transportation Services
• Kayla Packer
• Tracy Packer
• Tamela Danielle Pagel
• Pain Consultants of Central Illinois LLC

• Clinical Social Worker in Decatur, IL
• Providers in Decatur, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.