Kathleen Marie Berry, LCSW

Key facts

NPI

1740400613

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

Practice address

1852 W Church St
Sandwich, IL 60548-2069

Phone

(815) 786-7016

NPI assigned

Apr 26, 2007

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740400613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 CHESTNUT CIR",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605604548",
            "telephone_number": "708-420-5973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 W CHURCH ST",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605482069",
            "telephone_number": "815-786-7016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandwich, IL

• Phyllis Bainbridge, RN
• Sheila Barnette, PTA
• Ankur Rishi Behl, M.D.
• Laura Bell, RBT
• Ben Gordon Center
• Stephen C Beverley
• Jessica Birchall, OTR/L
• Brandi Kristen Boan, PSYD
• Martin Paul Brauweiler, M.D.
• Austin Breunig

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