Selina Harrison Kelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904010453 Issued in VA

Practice address

930 Cambria St NE Ste 100
Christiansburg, VA 24073-1631

Phone

(540) 944-4994

Fax

(540) 944-6446

NPI assigned

Apr 16, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• That Counseling Place, LLC

  • Clinical Social Worker
  • Christiansburg, VA
  • NPI 1083287676
  Medicare reassignment NPD Authorized official
• Amanda Hardwick, LCSW, PLLC

  • Clinical Social Worker
  • Christiansburg, VA
  • NPI 1932566049
  NPD
• Family Preservation Services LLC

  dba Clarvida

  • Community/Behavioral Health Agency
  • Roanoke, VA
  • NPI 1093891335
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1023505047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6605",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240686605",
            "telephone_number": "540-944-4994",
            "fax_number": "540-944-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 CAMBRIA ST NE STE 100",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240731631",
            "telephone_number": "540-944-4994",
            "fax_number": "540-944-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SELINA",
        "middle_name": "HARRISON",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023505047",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "selina@thatcounselingplace.com",
            "affiliation": "N",
            "address_1": "930 Cambria St NE Ste 100",
            "city": "Christiansburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240731631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Kardel
• Brittany Kark
• Nicholas Lindon Karo, MD
• Karlie B. Keen, CF-SLP
• Michael P Kelley, M.D.
• Ronald Dalton Kendall Jr., NRP, RN
• Leslie Jean Kennedy, OTR/L
• Ahmad Rehan Khan, MD
• Jiwon Kim, DDS
• Emily Kristy King, PA-C

• Clinical Social Worker in Christiansburg, VA
• Providers in Christiansburg, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.