NICOLE ANGELA KELLEY (NPI# 1659473437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659473437 |
| Entity Type | Individual |
| Full Name | NICOLE ANGELA KELLEY |
| Credential | LCSW |
| Practice Address |
112 Boeykens Pl Suite 4a Normal IL 61761-2152 |
| Mailing Address |
702 N Washington St Hudson IL 61748-9476 |
| Practice Telephone | 3092427925 |
| Practice Fax Number | 3094549521 |
| Mailing Telephone | 3092427925 |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2017-03-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149011400 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669967329 | Nicole Kelley | Massage Therapist | 5500 Main St Ste 106, Williamsville, NY 14221-6753 | 2018-06-26 |
| 1740647122 | Nicole Rose Kelley | Specialist | 63 Edgewood Ave, Walpole, MA 02081 | 2016-01-15 |
| 1942588140 | Nicole Latonya Kelley | Social Worker | 2801 S. Valley View Blvd, Suite #2, Las Vegas, NV 89102 | 2011-07-22 |
| 1285191817 | Nicole Kelley | Nurse Practitioner | 320 Alpenglow Ln, Livingston, MT 59047-8506 | 2019-03-01 |
| 1154840460 | Nicole Gail Kelley | Occupational Therapist | 112 N 3rd St, Leesville, LA 71446-4014 | 2017-09-18 |
| 1174049084 | Nicole Amanda Kelley | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115 | 2017-08-22 |
| Street Address |
112 BOEYKENS PL SUITE 4A |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-2152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972547388 | Jennifer Lynn Hamilton | Counselor | 112 Boeykens Pl, Suite 4a, Normal, IL 61761-2152 | 2006-06-15 |
| 1194181008 | Mary Ann Shelton | Massage Therapist | 112 Boeykens Pl, Suite 3e, Normal, IL 61761-2152 | 2016-01-07 |
| 1649653346 | Hometown Hearing & Audiology, Inc. | Audiologist | 112 Boeykens Pl, 4a, Normal, IL 61761-6161 | 2015-06-30 |
| 1922391259 | Tyson Newson | Specialist/Technologist, Other | 112 Boeykens Pl, Suite 2a, Normal, IL 61761 | 2011-05-19 |
| 1902102825 | Olga Tremud | Specialist/Technologist, Other | 112 Boeykens Pl, Ste. 2a, Normal, IL 61761-2152 | 2011-02-10 |
| 1982845095 | Colleen Dwyer | Specialist/Technologist, Other | 112 Boeykens Pl, Suite 2a, Normal, IL 61761 | 2009-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| 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 |
|---|---|---|---|---|
| 1710597372 | Lauren C Dilorenzo | Social Worker | 103 E Lincoln St Apt I, Normal, IL 61761-1450 | 2020-08-07 |
| 1407342777 | Jane Elizabeth Stilwell | Social Worker | 448 Wylie Dr, Normal, IL 61761-5405 | 2018-07-10 |
| 1114464781 | Nelson Family Counseling, LLC. | Social Worker | 705 E Lincoln St Ste 302, Normal, IL 61761-6406 | 2017-01-20 |
| 1023551306 | Laurie Krolikowski | Social Worker | 1306 Stephens Dr, Normal, IL 61761-3957 | 2016-11-18 |
| 1871946749 | Melissa Box | Social Worker | 705 E Lincoln St Ste 303, Normal, IL 61761-6406 | 2016-07-15 |
| 1437468105 | Julie M Stoll | Social Worker | 705 E Lincoln St, Suite 302, Normal, IL 61761-6406 | 2010-09-29 |
| 1699000554 | Lisa Nancy Dawn Flanagan | Social Worker | 103 W Vernon Ave, Normal, IL 61761-3714 | 2009-10-12 |
| 1497983613 | Jenna Rose Forrest Mangold | Social Worker | 706 Oglesby Ave, Suite 300, Normal, IL 61761-4616 | 2009-06-25 |
| 1972633501 | Carolyn Wilbur Treadway | Social Worker | 712 N School St, Normal, IL 61761-1621 | 2007-03-06 |
| 1598868473 | Jan Marie Reeder | Social Worker | 1100 Beech St, Bldg 83, Normal, IL 61761 | 2006-09-06 |
| Find all providers in NORMAL | ||||
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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.