Anne Marie Kelly, LICSW
Individual provider Active NPI Clinical Social Worker · Windsor, VT
NPI 1134588403 · NPPES record last updated Feb 16, 2016
Key facts
- NPI
- 1134588403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 089.0109571 (VT)
- Practice address
- 82 State St
Windsor, VT 05089-1276 - Phone
- (860) 301-3711
- NPI assigned
- Feb 16, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Connecticut Valley Addiction Recovery Inc
Practice addresses (Care Compare)
220 Holiday Dr
Suite a
White River Junction, VT 05001-2015
Phone (802) 674-9400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VT, NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220110000432 | VT | Practitioner - Clinical Social Worker | 3870985591 | Reassigns benefits to 2 organizations |
| I20220111000400 | NH | Practitioner - Clinical Social Worker | 3870985591 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 089.0109571 | VT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connecticut Valley Addiction Recovery, Inc | Current |
Accepting new patients |
Locations
220 Holiday Dr
Ste A
White River Junction, VT 05001
Phone (802) 281-6364
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089.0109571 | VT | Yes |
Addresses
Primary practice location
82 State St
Windsor, VT 05089-1276
Mailing address
82 State St
Windsor, VT 05089-1276
Other providers in Windsor, VT
- Donna M Jenkins
- Leslie Ann Joslin
- Mary K Joyce
- H Jeffrey Katchen
- David Raymond Keith Sr.
- Jeffrey R King
- Cynthia Jean Koch
- Maryann Lachapelle
- Peter Gilbert Lapre
- Katherine Jane Leary
All providers in Windsor, VT · Clinical Social Worker in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.