Individual provider Active NPI

Kelli Michelle Fox, LCSW

  • Clinical Social Worker
  • Henderson, KY
National Provider Identifier
1053644237
Registry record updated Sep 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
KY 3270 Issued in KY
Practice address
230 2ND St
Suite 406
Henderson, KY 42420-3172
Phone
(270) 826-8761
Fax
(270) 826-8737
NPI assigned
Sep 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X KY 3270 KY Primary

Addresses

Primary practice location

230 2ND St
Suite 406
Henderson, KY 42420-3172

Mailing address

230 2ND St
Suite 406
Henderson, KY 42420-3172
Phone (270) 826-8761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20130315000107 KY Practitioner - Clinical Social Worker 4587809850 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY 3270KYMDClinical Social Worker
3270KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Care Affiliates Inc CurrentSince Mar 16, 2020 Accepting new patients
Regional Health Care Affiliates, Inc. CurrentSince Mar 16, 2020 Accepting new patients
Stability Counseling and Associates LLC Clinical CurrentSince Dec 18, 2022 Accepting new patients

Locations

230 2nd St
Ste 406
Henderson, KY 42420
Phone (270) 826-8761

215 E Main St
#215
Providence, KY 42450

215 E Main St
Providence, KY 42450
Phone (270) 667-7017

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1252195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252195200000",
    "number": "1053644237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 2ND ST",
            "address_2": "SUITE 406",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424203172",
            "telephone_number": "270-826-8761",
            "fax_number": "270-826-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 2ND ST",
            "address_2": "SUITE 406",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424203172",
            "telephone_number": "270-826-8761",
            "fax_number": "270-826-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "KELLI",
        "middle_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-06",
        "last_updated": "2009-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "KY 3270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, KY

Sources for this page

Verify at the official NPI Registry.