Kelley Willig

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

254061 Issued in KY

Practice address

650 Joel Dr
Fort Campbell, KY 42223-5318

Phone

(270) 956-1777

NPI assigned

Nov 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelley-Jean M. Willig Other name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mindcare Mental Health Group

  • Clinical Social Worker
  • Hopkinsville, KY
  • NPI 1083474449
  NPD (past) Authorized official

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1083157028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3091 SINGLETREE DR",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422409115",
            "telephone_number": "270-985-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-956-1777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Canton St Ste 4H",
            "address_purpose": "LOCATION",
            "city": "Hopkinsville",
            "state": "KY",
            "postal_code": "422401383",
            "country_code": "US",
            "telephone_number": "270-985-1666",
            "fax_number": "866-650-4089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIG",
        "first_name": "KELLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "254061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY-JEAN",
            "last_name": "WILLIG",
            "middle_name": "M.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Saundeth A. Williams, RN
• Tammy M Williams, CNM
• Van R Williams, M.D.
• Willie Williams Jr., LPN
• Bethany M Williamson, D.O.
• Heather Nicole Willis, PSY.D.
• Michele Lynn Willis, CPHT
• Aaron Wilson
• Christopher Ray Wilson, PH.D.
• Damariun Wilson

• Clinical Social Worker in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.