Catherina Annette Kelly, LSCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4113 Issued in KS

Practice address

6201 College Blvd Ste 410
Overland Park, KS 66211-2430

Phone

(913) 652-6668

NPI assigned

Aug 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1033490495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 COLLEGE BLVD STE 410",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662112430",
            "telephone_number": "913-912-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 COLLEGE BLVD STE 410",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662112430",
            "telephone_number": "913-652-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CATHERINA",
        "middle_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "5582",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsie Kelley
• Dwain E Kelley, PT
• Kelly R. Moore Therapy LLC
• Abigael F Kelly, AUD
• Casandra Joyce Kelly, LCSW
• Dana Leigh Kelly, MSN-FNP
• Janet Kay Kelly, OTR
• Katie Blair Kelly, MPT
• Stacie Irene Kelly, APRN
• Sylvia Kelly

• Clinical Social Worker in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.