Individual provider Active NPI

Kristen Michelle Jopes, LCSW

  • Clinical Social Worker
  • Bolingbrook, IL
National Provider Identifier
1952058828
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149025250 Issued in IL
Practice address
550 E Boughton Rd Ste 265
Bolingbrook, IL 60440-2396
Phone
(708) 224-1001
NPI assigned
Mar 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150104697 IL
Clinical Social Worker 1041C0700X 149025250 IL Primary

Addresses

Primary practice location

550 E Boughton Rd Ste 265
Bolingbrook, IL 60440-2396

Mailing address

2S758 Timber Dr
Warrenville, IL 60555-2730
Phone (708) 224-1001

Other names 1

  • Kristen Michelle Larson Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230830001478 IL Practitioner - Clinical Social Worker 2961865571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

900 E Diehl Rd
Suite 101
Naperville, IL 60563-2394
Phone (888) 428-7890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150104697ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. Clinical CurrentSince Aug 7, 2023 Accepting new patients
Psychology Specialists LTD Clinical Past Accepting new patients

Locations

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

55 S Main St
Ste 252
Naperville, IL 60540
Phone (630) 238-0949

3027 English Rows Ave
Ste 201
Naperville, IL 60564

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

900 E Diehl Rd
Ste 101
Naperville, IL 60563
Phone (630) 328-0134

Organizations & group practices 2

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": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1952058828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2S758 TIMBER DR",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605552730",
            "telephone_number": "708-224-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E BOUGHTON RD STE 265",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402396",
            "telephone_number": "708-224-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOPES",
        "first_name": "KRISTEN",
        "middle_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-09",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150104697",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149025250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "LARSON",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.