Kelly Neal, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.024375 Issued in IL

Practice address

3050 Montvale Dr Ste C
Springfield, IL 62704-6924

Phone

(217) 679-6344

NPI assigned

Sep 27, 2022

Last updated

Sep 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1770207441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 MONTVALE DR STE C",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046924",
            "telephone_number": "217-679-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 MONTVALE DR STE C",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046924",
            "telephone_number": "217-679-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "850550240",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.luminarycounselingsolutions.com",
            "affiliation": "N",
            "endpointDescription": "web address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3050 Montvale Dr Ste C",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627046924",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.luminarycounselingsolutions.com",
            "affiliation": "N",
            "endpointDescription": "web address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3050 Montvale Dr Ste C",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627046924",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.luminarycounselingsolutions.com",
            "affiliation": "N",
            "endpointDescription": "web address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3050 Montvale Dr Ste C",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627046924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Archana Nayani, M.D.
• Rahul Nayani, MD
• Olivier Nday Bajima
• Charles Neal, MD
• Jessica Neal
• Tameya Neal
• Angela Neale, LCSW
• Neck to Back Springfield LLC
• Cody Derek Needham, DC
• Lacy Needham

• Clinical Social Worker in Springfield, IL
• Providers in Springfield, 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 27, 2022; 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.