Kelsey Nicole Collett

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

2269 N Kedzie Blvd Apt 1
Chicago, IL 60647-2591

Phone

(312) 819-7381

Fax

(312) 428-3093

NPI assigned

Mar 18, 2022

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

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, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Sage Therapy Chicago, PLLC

  dba Sage Therapy

  • Professional Counselor
  • Chicago, IL
  • NPI 1376154302
  Medicare reassignment NPD

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1922757988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4137 MAGNOLIA AVE APT 4",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631103946",
            "telephone_number": "630-310-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2269 N KEDZIE BLVD APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472591",
            "telephone_number": "312-819-7381",
            "fax_number": "312-428-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETT",
        "first_name": "KELSEY",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• College of Nursing Faculty Practice (Dunbar Vocational Career Academy)
• College of Nursing Faculty Practice (Rush Health Center at Simpson Academy)
• College of Nursing Faculty Practice (ORR Adolescent Health Center)
• Jennifer Christine Colleton, M.D.
• Margaret K Colleton
• Collette Ara Honore MDSC
• Collette Counseling and Consulting, PLLC
• Giavanna Renee Colletti
• Morgan Colletti, MSN,FNP-C
• Colliance Wellness PLLC

• Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.