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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.

KATHLEEN MARIE O'DIERNO LCSW
NPI 1760931356
Social Worker - Clinical in Rockford, IL

Active since September 24, 2016Opted out of Medicare · through Nov 11, 2027
129 PHELPS AVE STE 1005, ROCKFORD, IL 61108(815) 200-4966(815) 935-2429 Get Directions Write a Review

NPPES record last updated: August 29, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Aug 29, 2026, Dec 28, 2016, Sep 24, 2016 (3 updates tracked since 2016).

About Kathleen Marie O'dierno Lcsw NPPES

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

KATHLEEN MARIE O'DIERNO LCSW (NPI 1760931356) is an individual clinical provider in Rockford, Illinois, licensed in Illinois (149.018745) and active in the NPI registry since September 2016. She has opted out of Medicare through November 11, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1760931356
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKATHLEEN MARIE O'DIERNOCredential: LCSW
Location Address129 PHELPS AVE STE 1005Rockford, IL 61108-2456
Mailing Address129 Phelps Ave Ste 1005Rockford, IL 61108-2456 · (815) 200-4966 · Fax (815) 935-2429
Phone(815) 200-4966
Fax(815) 935-2429
Sole ProprietorYes
Enumeration DateSeptember 24, 2016
Last NPPES UpdateAugust 29, 20263 updates tracked since enumeration
NPPES CertifiedAugust 29, 2026
✔ NPI 1760931356 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 · 149.018745
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.
129 PHELPS AVE STE 1005, Rockford, IL 61108
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Kathleen Marie O'dierno Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 11, 2019 through November 11, 2027.

Opt-Out Effective DateNovember 11, 2019
Opt-Out In Effect ThroughNovember 11, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61108 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 Kathleen O'dierno's NPI number?

The NPI number for Kathleen O'dierno is 1760931356. It was assigned to this individual provider in the NPPES registry on September 24, 2016.

Where is Kathleen O'dierno located?

Kathleen O'dierno practices at 129 Phelps Ave Ste 1005, Rockford, IL 61108. The listed phone number is (815) 200-4966.

What is Kathleen O'dierno's specialty?

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

Is Kathleen O'dierno enrolled in Medicare?

No. Kathleen O'dierno has opted out of Medicare through November 11, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Kathleen O'dierno accept?

Health plans from Providence Health Plan list Kathleen O'dierno as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kathleen O'dierno was last updated on August 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.