Individual provider Active NPI

Kristina Lee Kiely

  • Clinical Social Worker
  • Red Bank, NJ
National Provider Identifier
1134715568
Registry record updated Jan 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05729 Issued in NJ
Practice address
31 Leroy PL
Red Bank, NJ 07701-1711
Phone
(732) 299-8040
NPI assigned
Dec 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05729 NJ Primary

Addresses

Primary practice location

31 Leroy PL
Red Bank, NJ 07701-1711

Mailing address

31 Leroy PL
Red Bank, NJ 07701-1711
Phone (732) 299-8040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SC05729NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1608422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611360000000",
    "number": "1134715568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 LEROY PL",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011711",
            "telephone_number": "732-299-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 LEROY PL",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011711",
            "telephone_number": "732-299-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELY",
        "first_name": "KRISTINA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-20",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2021; 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.