Anne Marie Kelly, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089.0109571 Issued in VT

Practice address

82 State St
Windsor, VT 05089-1276

Phone

(860) 301-3711

NPI assigned

Feb 16, 2016

Last updated

Feb 16, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in VT, NH2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Group practices

Connecticut Valley Addiction Recovery IncGroup PAC ID 1850710179, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Connecticut Valley Addiction Recovery, Inc

  • Addiction Medicine (Internal Medicine) Physician
  • Windsor, VT
  • NPI 1750932646
  Medicare reassignment Care Compare group NPD
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763

  NH, VT

  Medicare reassignment

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1134588403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 STATE ST",
            "city": "WINDSOR",
            "state": "VT",
            "postal_code": "050891276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 STATE ST",
            "city": "WINDSOR",
            "state": "VT",
            "postal_code": "050891276",
            "telephone_number": "860-301-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ANNE MARIE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0109571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna M Jenkins, OT
• Leslie Ann Joslin, APRN
• Mary K Joyce, MD
• H Jeffrey Katchen, PA-C
• David Raymond Keith Sr., CRNA
• Jeffrey R King, DPM
• Cynthia Jean Koch, B.S.
• Maryann Lachapelle
• Peter Gilbert Lapre, O.D.
• Katherine Jane Leary, BS, PHYSICAL THERAPY

• Clinical Social Worker in Windsor, VT
• Providers in Windsor, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.