Kristen Nickol, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149023456 Issued in IL

Practice address

479 Horizon Dr
Bartlett, IL 60103-1244

Phone

(773) 710-7637

NPI assigned

Sep 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1790154045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 HORIZON DR",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031244",
            "telephone_number": "773-710-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 HORIZON DR",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031244",
            "telephone_number": "773-710-7637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 E Superior St",
            "address_2": "Suite 306",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112507",
            "country_code": "US",
            "telephone_number": "312-754-9404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKOL",
        "first_name": "KRISTEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149023456",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lauren Nowak
• Jennifer Kay Nowakowski, DEVELOPMENTAL THERAP

• Clinical Social Worker in Bartlett, IL
• Providers in Bartlett, 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 Jul 24, 2024; 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.