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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MS. LISA MARIE KYLE-WOLF LCSW
NPI 1306819776
Social Worker - Clinical in East Peoria, IL

Active since February 08, 2006PECOS Enrolled
1281 SPRING BAY RD, EAST PEORIA, IL 61611(309) 696-8369(312) 254-1423 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 29, 2026, Jan 27, 2026, May 14, 2021 and 3 more (6 updates tracked since 2017).

About Ms. Lisa Marie Kyle-wolf Lcsw NPPES

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

MS. LISA MARIE KYLE-WOLF LCSW (NPI 1306819776) is an individual clinical provider in East Peoria, Illinois, licensed in Illinois (149002070) and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1988).

NPPES Registry Identity

NPI1306819776
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. LISA MARIE KYLE-WOLFCredential: LCSW
Location Address1281 SPRING BAY RDEast Peoria, IL 61611-9779
Mailing Address1281 Spring Bay RdEast Peoria, IL 61611-9779 · (309) 696-8369 · Fax (312) 254-1423
Phone(309) 696-8369
Fax(312) 254-1423
Sole ProprietorYes
Medical School CMSOtherGraduated 1988
Enumeration DateFebruary 8, 2006
Last NPPES UpdateSeptember 29, 20266 updates tracked since enumeration
NPPES CertifiedJanuary 27, 2026
✔ NPI 1306819776 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 · 149002070
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.
1281 SPRING BAY RD, East Peoria, IL 61611
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Other Names 1

Former Name (1)Lisa Marie Rutherford Lcsw

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Lisa Marie Kyle-wolf Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1456329341
PECOS Enrollment IDI20040920000013
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Lisa Kyle-wolf reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Board Of Trustees Of The University Of Illinois
6.6 mi
Pediatrics
1 ILLINI DR
Peoria, IL 61605
  • Reassigned Medicare billing, Illinois enrollment
  • 2,127 clinicians in this Medicare group
NPI 1467425322 (309) 680-8649

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61611 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.80 – $168.44
Typical copayment $0.00 (range $13.70 – $42.11)
Most-billed visit code NA
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Kyle-wolf's NPI number?

The NPI number for Lisa Kyle-wolf is 1306819776. It was assigned to this individual provider in the NPPES registry on February 8, 2006. The provider is also known as Lisa Marie Rutherford Lcsw.

Where is Lisa Kyle-wolf located?

Lisa Kyle-wolf practices at 1281 Spring Bay Rd, East Peoria, IL 61611. The listed phone number is (309) 696-8369.

What is Lisa Kyle-wolf's specialty?

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

Is Lisa Kyle-wolf enrolled in Medicare?

Yes. Lisa Kyle-wolf is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lisa Kyle-wolf's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Kyle-wolf reassigns Medicare benefits to Board Of Trustees Of The University Of Illinois (Peoria, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lisa Kyle-wolf's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Lisa Kyle-wolf was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 40 days 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.