Michael Paul Kellum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW025930 Issued in PA

Practice address

121 Pennsylvania Avenue
Avondale, PA 19311

Phone

(610) 897-2014

NPI assigned

Jul 28, 2026

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1785196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1134041445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 105",
            "city": "AVONDALE",
            "state": "PA",
            "postal_code": "193110105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PENNSYLVANIA AVENUE",
            "city": "AVONDALE",
            "state": "PA",
            "postal_code": "19311",
            "telephone_number": "610-897-2014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 W Hamlin Ave",
            "address_purpose": "LOCATION",
            "city": "Telford",
            "state": "PA",
            "postal_code": "189691448",
            "country_code": "US",
            "telephone_number": "267-279-9851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLUM",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-07-28",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW025930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Christine Heckman, MS OTR L
• Yeshiu B Ho, PHARMD
• Sherri Lynn Hollick, MA, CCC-SLP
• Steven Iezzi, ATC
• Susannah Call Jenks, MSPT
• Linda G. Everett, MD, PA
• Paulina Maida, M.D.
• Melssa Ann Mancini, MS, CCC-SLP
• Hillary Mattei
• Maximum Fitness Inc

• Clinical Social Worker in Avondale, PA
• Providers in Avondale, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.