Individual provider · Type 1 NPI

Kelley Nicole Larson, LSW

Clinical Social Worker · Rockford, IL

NPI number 1023764263 Active

Practice location

301 E State St
Rockford, IL 61104-1012

Call (815) 668-7810 Map

Mailing address

PO Box 746715
Atlanta, GA 30374-6715

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000X150105997 (IL)
Clinical Social Worker Primary 1041C0700X149.026923 (IL)

Clinical Social Worker: 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 interpers…

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About NPI 1023764263

Kelley Nicole Larson, LSW's National Provider Identifier is 1023764263, issued on Feb 25, 2022. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Rockford, IL. The record was last updated on Jun 11, 2025.