Active NPI
Alysia Kelley
- Clinical Social Worker
- Myrtle Beach, SC
National Provider Identifier
1053276873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16654
- Practice address
- 3876 Renee Dr Unit B
Myrtle Beach, SC 29579-4108 - Phone
- (843) 504-9972
- NPI assigned
- Dec 23, 2025
- Last updated
- Dec 23, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 16654 | SC | Primary |
Addresses
Primary practice location
3876 Renee Dr Unit B
Myrtle Beach, SC 29579-4108
Mailing address
3876 Renee Dr Unit B
Myrtle Beach, SC 29579-4108
Phone (843) 504-9972
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16654 | SC | MD | Body Imaging Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766448000000",
"number": "1053276873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3876 RENEE DR UNIT B",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295794108",
"telephone_number": "843-504-9972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3876 RENEE DR UNIT B",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295794108",
"telephone_number": "843-504-9972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "ALYSIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-23",
"last_updated": "2025-12-23",
"certification_date": "2025-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SC",
"license": "16654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.