MS. KELLI D CANADA (NPI# 1336664705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336664705 |
| Entity Type | Individual |
| Full Name | MS. KELLI D CANADA |
| Credential | LCSW |
| Practice Address |
525 N Vine St Arthur IL 61911-1130 |
| Practice Telephone | (217) 543-2446 |
| Practice Fax Number | 2175432548 |
| Mailing Telephone | 2175432446 |
| Mailing Fax Number | 2175432548 |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2017-08-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149019506 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578715165 | Kelli Elizabeth Canada | Social Worker | 2750 N. Racine Ave., Chicago, IL 60614 | 2008-10-15 |
| Street Address |
525 N VINE ST |
| City | ARTHUR |
| State | IL |
| Zip Code | 61911-1130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164418067 | William H Shackelford Md | Family Medicine | 525 N Vine St, Arthur, IL 61911-1137 | 2005-09-26 |
| 1134660590 | Kendra Zerrusen | Nurse Practitioner | 525 N Vine St, Arthur, IL 61911-1130 | 2017-03-17 |
| 1720419336 | Brittany Faris | Physician Assistant | 525 N Vine St, Arthur, IL 61911-1130 | 2013-12-06 |
| 1467445130 | William Howard Shackelford | Family Medicine | 525 N Vine St, Arthur, IL 61911-1137 | 2005-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508301706 | Southern Illinois Health Care Foundation, Inc. | Counselor | 1710 State Route 133, Arthur, IL 61911 | 2016-12-23 |
| 1568522605 | James E Winfield | Dentist | 318 South Ash, Arthur, IL 61911 | 2006-12-11 |
| 1356999262 | Shawna L Storm | Nurse Practitioner | 1710 State Route 133, Arthur, IL 61911 | 2019-09-04 |
| 1720164502 | Michael George Elder | Chiropractor | 426 North Vine Street, Arthur, IL 61911-1121 | 2006-10-27 |
| 1407833130 | Charles R Ellington | Family Medicine | 650 W Columbia St, Arthur, IL 61911-1214 | 2005-12-23 |
| 1952646457 | Barbara R Moody | Hearing Instrument Specialist | 431 W Palmer St, Suite 205, Arthur, IL 61911-1216 | 2012-12-10 |
| 1194721969 | Community Retirement, Inc. | Skilled Nursing Facility | 423 S Eberhardt Dr, Arthur, IL 61911-1224 | 2005-06-24 |
| 1114934759 | Keith E. Ballinger | Physician Assistant | 211 S Walnut St, Arthur, IL 61911-1269 | 2006-08-02 |
| 1881712438 | Sarah Bush Lincoln Health Center | Family Medicine | 211 S Walnut St, Arthur, IL 61911-1269 | 2007-03-26 |
| 1861508160 | Patrick Hartman | Family Medicine | 211 S Walnut St, Arthur, IL 61911-1269 | 2006-08-21 |
| Find all providers in zip 61911 | ||||
| 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 |
|---|---|---|---|---|
| 1447851241 | Courtney A Behrens | Social Worker | 150 Deerpath Rd, Algonquin, IL 60102-1861 | 2020-11-06 |
| 1801497623 | Sedulous Counseling & Consulting Services Pllc | Social Worker | 15255 S 94th Ave # 508, Orland Park, IL 60462-3800 | 2020-11-06 |
| 1295336022 | Web Healing Collective Pllc | Social Worker | 6207 N Springfield Ave, Chicago, IL 60659-1015 | 2020-11-06 |
| 1174124036 | Reginald Washington Edwards | Social Worker | 18660 Walnut Ave, Country Club Hills, IL 60478-5549 | 2020-11-05 |
| 1881295186 | Belva Marie Dibert | Social Worker | 6330 S Ingleside Ave Apt 3, Chicago, IL 60637-5784 | 2020-11-03 |
| 1801496468 | Monica Dushane | Social Worker | 125 N Buffalo Grove Rd Apt 110, Buffalo Grove, IL 60089-1722 | 2020-10-31 |
| 1528668373 | Stephanie Caballero Novak | Social Worker | Life Care Wellness, Inc., 800 Roosevelt Rd Building C Suite 206, Glen Ellyn, IL 60137 | 2020-10-30 |
| 1598365488 | Karyssa Lee Haase | Social Worker | 745 E Court St, Paris, IL 61944-2460 | 2020-10-29 |
| 1699375592 | Andrea Doherty | Social Worker | 526 Keystone Ave, River Forest, IL 60305-1612 | 2020-10-29 |
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
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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.