Kaleidoscope Mental Health, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KALEIDOSCOPE MENTAL HEALTH, PLLC

Practice address

722 Glenwood Dr
Charleston, IL 61920-3825

Phone

(217) 549-3741

NPI assigned

Sep 22, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sarah L Malak, MSW, LCSWNPI 1972775609

Title

Owner

Phone

(217) 549-3741

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sarah L Malak, LCSW

  • Clinical Social Worker
  • Charleston, IL
  • NPI 1972775609
  NPD Authorized official

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600732800000",
    "number": "1609482843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 GLENWOOD DR",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619203825",
            "telephone_number": "217-549-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 GLENWOOD DR",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619203825",
            "telephone_number": "217-549-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALEIDOSCOPE MENTAL HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "MALAK",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-549-3741",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sarah@kaleidoscopementalhealth.sprucecare.com",
            "affiliation": "N",
            "endpointDescription": "HIPAA compliant email platform",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "722 Glenwood Dr",
            "city": "Charleston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "619203825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James M Kohlmann MD SC
• Jason B Jerabek, DO
• Emma Johnson, LSW
• Journey Professional Counseling LLC
• Kwunho K Jung, D.M.D.
• Lois Karimu, BA, MHP
• Melissa K Kenter, APN
• Bailey Kiger, MS, CCLS
• John Robert Killough, DPM
• Michele Kinder, NP

• Clinical Social Worker in Charleston, IL
• Providers in Charleston, 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 Sep 22, 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.

Verify at the official NPI Registry.