MR. KEITH BULLOCK LCSW, CADC
NPI 1083569354
Social Worker - Clinical in Oak Park, IL

Active since March 03, 2026
607 GUNDERSON AVE, OAK PARK, IL 60304(708) 445-8194 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mr. Keith Bullock Lcsw, Cadc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KEITH BULLOCK LCSW, CADC (NPI 1083569354) is an individual clinical provider in Oak Park, Illinois, licensed in Illinois (149014572) and active in the NPI registry since March 2026.

NPPES Registry Identity

NPI1083569354
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. KEITH BULLOCKCredential: LCSW, CADC
Location Address607 GUNDERSON AVEOak Park, IL 60304-1421
Mailing Address607 Gunderson AveOak Park, IL 60304-1421 · (708) 445-8194
Sole ProprietorYes
Enumeration DateMarch 3, 2026
NPPES CertifiedMarch 2, 2026
NPI 1083569354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in IL · 149014572
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, 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.

607 GUNDERSON AVE, Oak Park, IL 60304

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083569354, enumerated as an "individual" on March 03, 2026.

The provider is located at 607 GUNDERSON AVE OAK PARK, IL 60304 and the phone number is (708) 445-8194.

Social Worker with taxonomy code 1041C0700X and a focus in Clinical.