Kelly Vierra, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.015248 Issued in IL

Practice address

4043 N Ravenswood Ave Ste 306D
Chicago, IL 60613-5683

Phone

(773) 807-8474

NPI assigned

Jul 2, 2014

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kelly Vierra, LCSW, LLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1326696154
  Medicare reassignment NPD Authorized official
• The Josselyn Center NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Northbrook, IL
  • NPI 1073548640
  Medicare reassignment NPD
• The Josselyn Center NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grayslake, IL
  • NPI 1841078714
  NPD

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1609282227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4043 N RAVENSWOOD AVE STE 306D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135683",
            "telephone_number": "773-807-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4043 N RAVENSWOOD AVE STE 306D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135683",
            "telephone_number": "773-807-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIERRA",
        "first_name": "KELLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia Jane Vielmetti
• Albert Vien, M.D., M.S.
• Tu Nhu Huynh Vien, DC, L.AC
• Viento Dental
• Emily Morgan Vierow, PT, DPT
• Vietnamese Association of Illinois
• Bridget Vietor
• Sandra Vieyra-Kapusniak, LCSW
• Carlos Enrique Vigil, MD
• Alexandra Vigilante Chamberlin, PA-C

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Apr 15, 2022; 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.