MS. KELLY JOSETTE MEDLIN (LCSW) – Clinical Social Worker, NPI 1083859821

MS. KELLY JOSETTE MEDLIN (LCSW) is a healthcare provider. based in Alton, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. The NPI Number for MS. KELLY JOSETTE MEDLIN (LCSW) is 1083859821

Main info

Female
32 Years Of Experience
Accepts Medicare Assignment
Name
MS. KELLY JOSETTE MEDLIN (LCSW)
NPI
1083859821
Phone
(618) 462-2331
Address
2615 EDWARDS ST
Enumeration Date
9 December 2008
Last Update Date
9 December 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6188572700
Graduation Year
1994 (32 years ago)
PAC ID
7214083120
Group Practice PAC ID
7416843370
Professional Enrollment ID
I20090917000599
Address ID
IL622062822SA2071XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:17State licenses:0Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

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Provider Addresses for MS. KELLY JOSETTE MEDLIN (LCSW)

  • 2615, Edwards Street, Milton, Alton, Madison County, Illinois, 62002, United States

    ALTON, IL 620023915

    Phone: (618) 462-2331

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-09-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090917000599IClinical Social WorkerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62002)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416843370View full group profile
NameSpecialtyState
P S Y C H I A T R YIL
Mental Health CounselorIL
Cardiovascular Disease (Cardiology)IL
Gastroenterology, Internal MedicineMO
Nurse PractitionerIL
Cardiovascular Disease (Cardiology), Interventional CardiologyIL
Internal Medicine, Cardiovascular Disease (Cardiology)MO
Internal MedicineIL
P S Y C H I A T R YIL
Cardiovascular Disease (Cardiology)IL

Reviews

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Frequently asked questions

Is there an official ID for MS. KELLY JOSETTE MEDLIN (LCSW) in U.S. healthcare records?
The official identifier for MS. KELLY JOSETTE MEDLIN (LCSW) is NPI 1083859821.
Is there an active status for MS. KELLY JOSETTE MEDLIN (LCSW)?
For scheduling context, MS. KELLY JOSETTE MEDLIN (LCSW) is shown as active in the registry.
What kind of doctor is MS. KELLY JOSETTE MEDLIN (LCSW)?
MS. KELLY JOSETTE MEDLIN (LCSW) is associated with Clinical Social Worker in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for MS. KELLY JOSETTE MEDLIN (LCSW)?
Travel planning: use Alton, Illinois as the reference point for MS. KELLY JOSETTE MEDLIN (LCSW), then confirm.
Does MS. KELLY JOSETTE MEDLIN (LCSW) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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