Nancykkinley

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

149.010286 Issued in IL

Legal business name

NANCYKKINLEY

Practice address

105 Hilltop St
Colona, IL 61241-8819

Phone

(309) 945-7969

Fax

(309) 441-6085

NPI assigned

Feb 11, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Nancy Kerr Kinley, LCSW

Title

Therapist

Phone

(309) 945-7969

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1619368693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 HILLTOP ST",
            "city": "COLONA",
            "state": "IL",
            "postal_code": "612418819",
            "telephone_number": "309-945-7969",
            "fax_number": "309-441-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HILLTOP ST",
            "city": "COLONA",
            "state": "IL",
            "postal_code": "612418819",
            "telephone_number": "309-945-7969",
            "fax_number": "309-441-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANCYKKINLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2015-02-11",
        "status": "A",
        "authorized_official_last_name": "KINLEY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "KERR",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "309-945-7969",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "IL",
            "license": "149.010286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Thriving Lifestyles Counseling Solutions, LLC

• Early Intervention Provider Agency in Colona, IL
• Providers in Colona, IL by specialty
• Early Intervention Provider Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.