MS. KELLY M. O'HERN (LCSW) – Clinical Social Worker, NPI 1174749824

MS. KELLY M. O'HERN (LCSW) is a healthcare provider. based in Morris, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 149014050 (IL). The NPI Number for MS. KELLY M. O'HERN (LCSW) is 1174749824

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
MS. KELLY M. O'HERN (LCSW)
NPI
1174749824
Phone
(815) 942-6323
Address
1401 LAKEWOOD DR
Enumeration Date
18 April 2007
Last Update Date
24 January 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8154678181
Graduation Year
2005 (21 years ago)
PAC ID
4385805282
Group Practice PAC ID
5496093213
Professional Enrollment ID
I20120420000342
Address ID
IL604105256CH25224STXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

Provider Addresses for MS. KELLY M. O'HERN (LCSW)

  • 1401 LAKEWOOD DR

    SUITE A

    MORRIS, IL 604503352

    Phone: (815) 942-6323

    Fax: (815) 942-6423

    Type: Mailing

  • 210 N HAMMES AVE

    SUITE 103

    JOLIET, IL 604356680

    Phone: (815) 942-6323

    Fax: (815) 942-6423

    Type: Location

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: 2012-04-20

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
I20120420000342IClinical 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 60450)

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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: 5496093213View full group profile
NameSpecialtyState
Mental Health CounselorIL
Clinical Social WorkerIL
Clinical Social WorkerIL
Mental Health CounselorIL
Clinical Social WorkerIL
Mental Health CounselorIL
Clinical Social WorkerIL
Mental Health CounselorIL
Mental Health CounselorIL
Clinical Social WorkerIL

Reviews

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Frequently asked questions

What is the registry number for MS. KELLY M. O'HERN (LCSW)?
The registry entry for MS. KELLY M. O'HERN (LCSW) shows NPI 1174749824.
Is MS. KELLY M. O'HERN (LCSW)'s NPI status active today?
Active status means MS. KELLY M. O'HERN (LCSW)'s NPI record is not deactivated in the public file.
How should patients interpret MS. KELLY M. O'HERN (LCSW)'s specialty?
The extract shows Clinical Social Worker for MS. KELLY M. O'HERN (LCSW). Clinical services aligned with this taxonomy classification.
Which community is linked to MS. KELLY M. O'HERN (LCSW)?
MS. KELLY M. O'HERN (LCSW) shows a connection to Morris, Illinois in registry-derived data.
Who maintains MS. KELLY M. O'HERN (LCSW)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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