Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miss. Kimberley B Herzog, LISW-S

Individual provider Mental Health Counselor · NPI 1134585441

Miss. Kimberley B Herzog, LISW-S is a Clinical Social Worker in Peoria, Illinois. Graduated from Washington University School of Medicine in 2005, 21 years ago. Practices with Osf Multi-Specialty Group, a 2,128-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois and Ohio.

Years since qualifying
21
Trained at
Washington University School of Medicine
Licensed in
IL, OH
In the registry since
2016
Specialties on file
3
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Practice location Address checks out

5111 N Glen Park Place Rd
Peoria, IL 61614-4675
Phone: (309) 683-5700
Fax: (309) 683-5752
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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 149021356 (IL)
Mental Health Counselor Taxonomy 101YM0800X · Licence I1501458S (OH)
Social Worker Taxonomy 104100000X · Licence 149021356 (IL)

Record details

NPI number1134585441
Entity typeIndividual (Type 1)
GenderFemale
Credentials LISW-S
Sole proprietorNo
NPI enumeratedJanuary 4, 2016
Last updated in NPPESAugust 12, 2019

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolWASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 2005 (21 years in practice)
Group practice Osf Multi-Specialty Group — 2128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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