Kathleen Reese, LCSW

Individual provider Active NPI Clinical Social Worker · Rockton, IL

NPI 1669962023 · NPPES record last updated May 11, 2018

Key facts

NPI
1669962023
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149004820 (IL)
Practice address
158 Quantico Dr
Rockton, IL 61072-2820
Phone
(815) 289-1648
NPI assigned
May 11, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
149004820ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149004820 IL Yes

Addresses

Primary practice location

158 Quantico Dr
Rockton, IL 61072-2820

Mailing address

158 Quantico Dr
Rockton, IL 61072-2820
Phone (815) 289-1648

Other providers in Rockton, IL

All providers in Rockton, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.