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

Individual provider Mental Health Counselor · NPI 1497495246

Kylie Marie Kotak, LCSW is a Clinical Social Worker in Evanston, Illinois. Qualified in 2021, 5 years ago. Practices with Edgewood Clinical Services PC, a 292-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
5
Licensed in
IL
In the registry since
2022
Specialties on file
2
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

1007 Church St
Evanston, IL 60201-3624
Phone: (847) 440-5760
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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 149.027729 (IL)
Mental Health Counselor Taxonomy 101YM0800X · Licence 149.027729 (IL)

Record details

NPI number1497495246
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMarch 30, 2022
Last updated in NPPESApril 28, 2026
Certification dateApril 28, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Edgewood Clinical Services P.C. — 292 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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