MRS. KATHRYN KELLY CARROLL (NPI# 1992999114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992999114 |
| Entity Type | Individual |
| Full Name | MRS. KATHRYN KELLY CARROLL |
| Other Name | MISS KATHRYN KELLY BULLA |
| Credential | LCSW |
| Practice Address |
1645 W Jackson Blvd Ste 302 Chicago IL 60612-3276 |
| Mailing Address |
1645 W Jackson Blvd Ste 302 Chicago IL 60612-1336 |
| Practice Telephone | 6084388865 |
| Mailing Telephone | 3125634630 |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2017-06-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149.016164 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740261361 | Kathryn Carroll | Physical Therapist | 800 Route 28, Summerfield Park, Mashpee, MA 02649-3303 | 2005-11-10 |
| 1093226763 | Kathryn Conner Carroll | Nurse Practitioner | 17280 Highway 17, Lexington, MS 39095-6614 | 2017-10-20 |
| 1982086880 | Kathryn Ford Carroll | Pediatrics | 85 John Maddox Drive Connector Nw, Rome, GA 30165-1233 | 2015-06-26 |
| 1225172125 | Kathryn Carroll | Psychologist | 200 Tyre Ave, Newark, DE 19711-7136 | 2007-02-16 |
| Street Address |
1645 W JACKSON BLVD STE 302 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-3276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639169279 | Sandra Swantek | Psychiatry & Neurology | 1645 W Jackson Blvd, Suite 600, Chicago, IL 60612-3276 | 2005-10-25 |
| 1083108054 | Natalia Salazar | Pediatrics | 1645 W Jackson Blvd, Chicago, IL 60612-3276 | 2018-06-21 |
| 1912491804 | Pooja Mehta | Pediatrics | 1645 W Jackson Blvd, Chicago, IL 60612-3276 | 2018-06-14 |
| 1295228237 | Kathleen Alicia Burns | Pediatrics | 1645 W Jackson Blvd, Chicago, IL 60612-3276 | 2018-06-13 |
| 1275026353 | Jessica Ann Korpics | Pediatrics | 1645 W Jackson Blvd, Chicago, IL 60612-3276 | 2018-06-12 |
| 1790278109 | Andrew Mcgurn | Internal Medicine | 1645 W Jackson Blvd, Chicago, IL 60612-3276 | 2018-06-11 |
| 1184116386 | Arnaud Jean Wautlet | Internal Medicine | 1645 W Jackson Blvd, Chicago, IL 60612-3276 | 2018-06-04 |
| 1881186534 | Jonathan Eric Mannheim | Pediatrics | 1645 W Jackson Blvd, Chicago, IL 60612-3276 | 2018-05-30 |
| 1205357548 | Elizabeth Guenther Harmon | Internal Medicine | 1645 W Jackson Blvd, Chicago, IL 60612-3276 | 2017-06-27 |
| 1407377781 | Adam Hutnik | Pediatrics | 1645 W Jackson Blvd, Chicago, IL 60612-3276 | 2017-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336022 | Web Healing Collective Pllc | Social Worker | 6207 N Springfield Ave, Chicago, IL 60659-1015 | 2020-11-06 |
| 1881295186 | Belva Marie Dibert | Social Worker | 6330 S Ingleside Ave Apt 3, Chicago, IL 60637-5784 | 2020-11-03 |
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1164022422 | Brittany Lauren Gatchell | Social Worker | 7448 N Damen Ave Apt 3n, Chicago, IL 60645-2258 | 2020-10-27 |
| 1467052803 | Seri Elaine Porter | Social Worker | 4258 N Greenview Ave Apt 2d, Chicago, IL 60613-1173 | 2020-10-26 |
| 1255930707 | Emily Ehrens | Social Worker | 303 W Institute Pl Ste 300, Chicago, IL 60610-3080 | 2020-10-25 |
| 1316546955 | Yesenia Maldonado | Social Worker | 3922 N Sayre Ave, Chicago, IL 60634-2329 | 2020-10-24 |
| 1144829201 | Andrea Hohf, Mscd, Lcsw | Social Worker | 564 W Randolph St Ste 248, Chicago, IL 60661-2218 | 2020-10-20 |
| 1215536693 | Miracleworks Therapy & Consulting LLC | Social Worker | 2138 S Indiana Ave, Chicago, IL 60616-4930 | 2020-10-18 |
| 1104425552 | Fifth Star Collective, LLC | Social Worker | 2711 N Lawndale Ave Unit 2, Chicago, IL 60647-1127 | 2020-10-17 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.