Kathleen Mary Kelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS13648 Issued in CA

Practice address

5855 E Naples PLZ
Ste 210
Long Beach, CA 90803-5080

Phone

(562) 987-3335

Fax

(562) 930-1095

NPI assigned

Nov 15, 2006

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

Medicare fee-for-service enrollment

Enrolled in CA

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, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1114099082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 E NAPLES PLZ",
            "address_2": "STE 210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908035080",
            "telephone_number": "562-987-3335",
            "fax_number": "562-930-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 E NAPLES PLZ",
            "address_2": "STE 210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908035080",
            "telephone_number": "562-987-3335",
            "fax_number": "562-930-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS13648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Kelley, OTR/L
• Lynetta J Kelley, NP
• Kellie Lockwood-Rios, Individual and Family Therapy
• Daizohn Kelly
• Emily Michelle Kelly, MA, CCC-SLP
• Loretta Kelly
• Madeleine Kelly, LMFT
• Mark J Kelly, MT, AP, BA
• Melissa Faith Kelly, LCSW
• Patricia A Kelly, NMD, FNP-BC, GNPC-BC

• Clinical Social Worker in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.