Kathleen a Kruse LCSW PC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

149007392 Issued in IL

Legal business name

KATHLEEN A KRUSE LCSW PC

Practice address

1011 W Loras Drive
Suite C
Freeport, IL 61032-6900

Phone

(815) 233-2550

NPI assigned

Feb 7, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Kathleen A Kruse, LCSW

Title

Owner

Phone

(815) 233-2550

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1669744678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W LORAS DRIVE",
            "address_2": "SUITE C",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326900",
            "telephone_number": "815-233-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W LORAS DRIVE",
            "address_2": "SUITE C",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326900",
            "telephone_number": "815-233-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN A KRUSE LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-233-2550",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149007392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Freeport, IL
• Providers in Freeport, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.