Kelly L. Carpenter, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C004488 Issued in NC

Practice address

1010 S Main St
Mount Holly, NC 28120-2021

Phone

(704) 228-9289

NPI assigned

May 23, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2019 through Jul 1, 2027

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.

• Well Balanced Counseling and Consulting PLLC

  • Clinical Social Worker
  • Mount Holly, NC
  • NPI 1700346277
  NPD Authorized official

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1124238530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 391",
            "city": "MC ADENVILLE",
            "state": "NC",
            "postal_code": "281010391",
            "telephone_number": "704-228-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S MAIN ST",
            "city": "MOUNT HOLLY",
            "state": "NC",
            "postal_code": "281202021",
            "telephone_number": "704-228-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "KELLY",
        "middle_name": "L.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "146AY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole M Cady, RD, LDN, CNSC
• Carolina Family Spine Center, PC
• Carolina Speech Academy, PLLC
• Carolinas Physicians Network Inc
• Caromont Medical Group Inc
• Tomas F Chao, LAT, ATC
• Charleys Drugs & Sundries Inc
• Ashley Chidester
• Marlene King Chisholm, RN
• Citizens Choice Home Care LLC

• Clinical Social Worker in Mount Holly, NC
• Providers in Mount Holly, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.