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

Mrs. Kelley Nicole Larson, LSW

Individual provider Social Worker · NPI 1023764263

Mrs. Kelley Nicole Larson, LSW is a Clinical Social Worker in Rockford, Illinois. Qualified in 2018, 8 years ago. Practices with Oak Street Health Physicians Group PC, a 234-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
8
Licensed in
IL
In the registry since
2022
Specialties on file
2
What do these letters mean?
LSW — Licensed Social Worker
A state-licensed social worker.

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Practice location Address checks out

301 E State St
Rockford, IL 61104-1012
Phone: (815) 668-7810
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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 149.026923 (IL)
Social Worker Taxonomy 104100000X · Licence 150105997 (IL)

Record details

NPI number1023764263
Entity typeIndividual (Type 1)
GenderFemale
Credentials LSW
Sole proprietorNo
NPI enumeratedFebruary 25, 2022
Last updated in NPPESJune 11, 2025
Certification dateJune 11, 2025

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Oak Street Health Physicians Group Pc — 234 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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