NPIMap

Individual provider Active NPI

Laurie K Kelly, LCSW

  • Clinical Social Worker
  • Lisle, IL
National Provider Identifier
1871964072
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012358 Issued in IL
Practice address
6020 Oakwood Dr
Unit 4D
Lisle, IL 60532-3088
Phone
(630) 730-2269
NPI assigned
Oct 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.012358 IL Primary

Addresses

Primary practice location

6020 Oakwood Dr
Unit 4D
Lisle, IL 60532-3088

Mailing address

6020 Oakwood Dr
Unit 4D
Lisle, IL 60532-3088
Phone (630) 730-2269

Other names 1

  • Laurie Scharf Kassel Other name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.012358ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cognitive Care Counseling, PLLC Clinical Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1871964072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 OAKWOOD DR",
            "address_2": "UNIT 4D",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323088",
            "telephone_number": "630-730-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 OAKWOOD DR",
            "address_2": "UNIT 4D",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323088",
            "telephone_number": "630-730-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LAURIE",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "KASSEL",
            "middle_name": "SCHARF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.