Lisa Kelly Jones

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149021475 Issued in IL

Practice address

710 Peoria St
Peru, IL 61354-3262

Phone

(815) 780-0690

NPI assigned

Mar 14, 2018

Last updated

Dec 12, 2024By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Maitri Path to Wellness PLLCGroup PAC ID 5395147714, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maitri Path to Wellness PLLC

  • Clinical Social Worker
  • Peru, IL
  • NPI 1184204950

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD
• Maitri Path to Wellness PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Peru, IL
  • NPI 1053018242
  NPD (past)
• Maitri Path to Wellness PLLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Peru, IL
  • NPI 1184359168
  NPD (past)
• Maitri Path to Wellness, PLLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Wyoming, IL
  • NPI 1598564429
  NPD (past)
• Maitri Path to Wellness, PLLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Henry, IL
  • NPI 1841099777
  NPD (past)

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1831692078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 PEORIA ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613543262",
            "telephone_number": "815-780-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 PEORIA ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613543262",
            "telephone_number": "815-780-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "LISA",
        "middle_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "34549",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149021475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Barry Jackson, OD
• Elizabeth Sue Jennings-Porter, CNM
• Jacob Joachim, PHARMD
• Joel S. Leifheit M.D., P.C.
• Karissa Lee Johnson, RPH
• Joseph Kunnel DDS, PHD, PC
• Jill Kamphaus
• Connor Kasik
• Patcharaporn Keane, PHARMD
• Tara Ketner, RDN, LDN

• Clinical Social Worker in Peru, IL
• Providers in Peru, 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 Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.