Kathryn Kelly Carroll in Chicago - Clinical
Kathryn Kelly Carroll - NPI 1992999114
Kathryn Kelly Carroll is a Clinical in Chicago, Illinois. Kathryn Kelly Carroll practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kathryn Kelly Carroll is 1992999114. The last update date is 2017-06-06.
Kathryn Kelly Carroll's current location address is 1645 W Jackson Blvd, Chicago, Illinois. You can contact this provider via phone number 6084388865. The mailing address for Kathryn Kelly Carroll is 1645 W Jackson Blvd, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kathryn Kelly Carroll |
|---|---|
| Address | 1645 W Jackson Blvd, Chicago, Illinois |
| Phone Number | 6084388865 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1992999114 |
|---|---|
| Provider Enumeration Date | 2007-08-30 |
| Last Updated Date | 2017-06-06 |
Provider Mailing Address Detail
| Address | 1645 W Jackson Blvd |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606123276 |
| Phone Number | 6084388865 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 149.016164 |
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Definition: 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, certif |
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What is the unique 10-digit identifier code issued to Kathryn Kelly Carroll by the Centers for Medicare & Medicaid Services?
The Kathryn Kelly Carroll has been assigned the NPI (National Provider Identifier) 1992999114 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Kathryn Kelly Carroll?
The Kathryn Kelly Carroll is physically situated at 1645 W Jackson Blvd, in the city of Chicago, state of IL, with the postal code 606123276.
What is Kathryn Kelly Carroll's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kathryn Kelly Carroll's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 1041C0700X.
On what date did Kathryn Kelly Carroll receive its 1992999114 assignment from the Centers for Medicare & Medicaid Services?
The Kathryn Kelly Carroll was assigned its 1992999114 on 2007-08-30, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Kathryn Kelly Carroll last refreshed?
The information related to the Kathryn Kelly Carroll, including its address, specialty, and other relevant details, was last updated on 2017-06-06.