Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kirstie Ruckoldt, LCSW

Individual provider Clinical Social Worker · NPI 1508728478

Kirstie Ruckoldt, LCSW is a Clinical Social Worker in Elburn, Illinois. Qualified in 2009, 17 years ago. Licensed in Illinois.

Years since qualifying
17
Licensed in
IL
In the registry since
2025
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

21 S Main St Unit A
Elburn, IL 60119-9194
Phone: (217) 471-4229
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 149.026470 (IL)

Record details

NPI number1508728478
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedDecember 1, 2025
Last updated in NPPESDecember 1, 2025
Certification dateDecember 1, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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