Mrs Kelley Nicole Larson, LSW | |
301 E State St, Rockford, IL 61104-1012 | |
(815) 668-7810 | |
Not Available |
Full Name | Mrs Kelley Nicole Larson |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 301 E State St, Rockford, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023764263 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 149.026923 (Illinois) | Primary |
104100000X | Social Worker | 150105997 (Illinois) | Secondary |
Entity Name | Oak Street Health Physicians Group Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083051643 PECOS PAC ID: 7517109879 Enrollment ID: O20130815000670 |
Mailing Address | Practice Location Address |
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Mrs Kelley Nicole Larson, LSW 1021 N Mulford Rd, Rockford, IL 61107-3874 Ph: () - | Mrs Kelley Nicole Larson, LSW 301 E State St, Rockford, IL 61104-1012 Ph: (815) 668-7810 |
Kelly Finch, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 4320 Spring Creek Rd, Ste 19, Rockford, IL 61107 Phone: 815-222-9485 | |
Mrs. Jessica M Gregg, MSW LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5758 Elaine Dr Ste 101c, Rockford, IL 61108 Phone: 815-975-1177 | |
Miss Marcy L Turek, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1601 Parkview Ave, University Psychiatric Services, Rockford, IL 61107 Phone: 815-395-5874 Fax: 815-395-5644 | |
Stephanie A Johnson, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 4835 Manhattan Dr Ste 4, Rockford, IL 61108 Phone: 815-520-2303 | |
Dana Stephen Kiley, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2823 Glenwood Ave, Rockford, IL 61101 Phone: 815-968-5342 Fax: 815-968-4656 | |
Paula Tripodi, L.C.S.W. Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 6735 Vistagreen Way Ste 210, Rockford, IL 61107 Phone: 815-742-7489 Fax: 815-904-6419 |