Kelly Mazur, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

6549 Town Center Dr Ste a
Clarkston, MI 48346-4824

Phone

(248) 620-6400

NPI assigned

Feb 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1144611708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6549 TOWN CENTER DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6549 TOWN CENTER DR STE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464824",
            "telephone_number": "248-620-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUR",
        "first_name": "KELLY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Matts, OTR
• Tyler Matts
• Alexandra Marie Mausolf, PT, DPT
• Catherine M May, M.A., CCC-A
• Arlene Mazo
• Natalie Marie McBryde
• Brandi McCadney, LLMSW
• Janna McCann
• Jill Louise McCarthy-Mitchell, MA,LLP,LMFT
• Jennifer McCarty, DDS

• Clinical Social Worker in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.