Provider Demographics
NPI:1487959847
Name:KELLEY, STARLENE (LCSW, CADC)
Entity type:Individual
Prefix:MRS
First Name:STARLENE
Middle Name:
Last Name:KELLEY
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:STARLENE
Other - Middle Name:
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4320 WINFIELD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-4023
Mailing Address - Country:US
Mailing Address - Phone:312-801-5100
Mailing Address - Fax:
Practice Address - Street 1:4320 WINFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-4023
Practice Address - Country:US
Practice Address - Phone:312-801-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-17
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490147661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical