Teresa Kelly, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R0558451 Issued in NY

Practice address

48 13TH St
Locust Valley, NY 11560-1526

Phone

(516) 676-0705

NPI assigned

May 24, 2007

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

Medicare fee-for-service enrollment

Enrolled in NY

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, 1989

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

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989

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.

• New Yaork State Association for Retarded Children Inc - Nassau County

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Plainview, NY
  • NPI 1891864179
  NPD (past)

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1053522102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 13TH ST",
            "city": "LOCUST VALLEY",
            "state": "NY",
            "postal_code": "115601526",
            "telephone_number": "516-676-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 13TH ST",
            "city": "LOCUST VALLEY",
            "state": "NY",
            "postal_code": "115601526",
            "telephone_number": "516-676-0705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Cedar Swamp Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Glen Cove",
            "state": "NY",
            "postal_code": "115423746",
            "country_code": "US",
            "telephone_number": "516-456-5401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TERESA",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0558451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Cecile Hiestand, OTR/L
• Anne W. Jauregui
• Alexandra Jeffery, LMHC
• Jouvence LLC
• James Kalenderian, P.T.
• Brandon Hoongyung Kim
• Samantha Kostopoulos, LMHC
• Robin Shane Kozlowski, DDS
• Kristen Whelan, LCSW P.C.
• Janine Marie Lawrence, REGISTERED NURSE

• Clinical Social Worker in Locust Valley, NY
• Providers in Locust Valley, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.