Individual provider Active NPI

Brad Kelley, LCSW, LCAC

  • Clinical Social Worker
  • Liberty, IN
National Provider Identifier
1154490316
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006759A Issued in IN
Practice address
950 N Market St
Liberty, IN 47353-8496
Phone
(765) 458-5191
Fax
(765) 458-7301
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
87000659AINMDAddiction (Substance Use Disorder) Counselor
34006759AINMDClinical Social Worker

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 87000659A IN
Clinical Social Worker 1041C0700X 34006759A IN Primary

Addresses

NPPES NPI Registry

Primary practice location

950 N Market St
Liberty, IN 47353-8496

Mailing address

5653 Willow Grove Rd
Centerville, IN 47330-9719
Phone (937) 248-4680

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 24, 2026.

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1154490316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5653 WILLOW GROVE RD",
            "city": "CENTERVILLE",
            "state": "IN",
            "postal_code": "473309719",
            "telephone_number": "937-248-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N MARKET ST",
            "city": "LIBERTY",
            "state": "IN",
            "postal_code": "473538496",
            "telephone_number": "765-458-5191",
            "fax_number": "765-458-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "BRAD",
        "credential": "LCSW, LCAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000659A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006759A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, IN

Sources for this page

Verify at the official NPI Registry.