MS. KELLY A KAVANAGH LCSW
NPI 1306111703
Social Worker - Clinical in Waukegan, IL

Q: What is Kelly Kavanagh's NPI number?

The NPI number for Kelly Kavanagh is 1306111703. It was assigned to this individual provider in the NPPES registry on March 19, 2012.

Q: What is Kelly Kavanagh's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Kavanagh was last updated on December 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 19, 2012

3010 GRAND AVE, WAUKEGAN, IL 60085(847) 377-8950(847) 984-5602 Get Directions Write a Review

NPPES record last updated: December 30, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 30, 2020, Oct 25, 2020 (2 updates tracked since 2020).

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About Ms. Kelly A Kavanagh Lcsw NPPES

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

MS. KELLY A KAVANAGH LCSW (NPI 1306111703) is an individual clinical provider in Waukegan, Illinois, licensed in Illinois (149.022674) and active in the NPI registry since March 2012. She maintains a secondary practice location in Hainesville.

NPPES Registry Identity

NPI1306111703

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMS. KELLY A KAVANAGHCredential: LCSW

Location Address3010 GRAND AVEWaukegan, IL 60085-2321

Mailing Address3010 Grand AveWaukegan, IL 60085-2321 · (847) 377-8950 · Fax (847) 984-5602

Phone(847) 377-8950

Fax(847) 984-5602

Sole ProprietorYes

Enumeration DateMarch 19, 2012

Last NPPES UpdateDecember 30, 20202 updates tracked since enumeration

NPPES CertifiedDecember 30, 2020

✔ NPI 1306111703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in IL · 149.022674

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.

Also ListedSocial WorkerTaxonomy 104100000X · License 150.013270 (IL)

3010 GRAND AVE, Waukegan, IL 60085

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Secondary Practice Location 1

Location 129 W Big Horn DrHainesville, IL 60073-4722 · Phone (224) 715-3078

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDA METTS

Counselor (Addiction (Substance Use Disorder))