MRS. Kelley Nicole Larson, LSW

NPI #1023764263 in Rockford, Illinois

Provider Information

NPI Number: 1023764263
Entity Type: Individual
Name: MRS. Kelley Nicole Larson, LSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: LSW
Enumeration Date: Feb 25, 2022
Last Updated: Jun 11, 2025

Practice Location

Address: 301 E STATE ST
City: Rockford
State: Illinois
ZIP Code: 61104-1012
Phone: (815) 668-7810

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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