Active NPI
Brad Kelley, LCSW, LCAC
- Clinical Social Worker
- Liberty, IN
National Provider Identifier
1154490316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34006759A
- 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
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.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87000659A | IN | MD | Addiction (Substance Use Disorder) Counselor |
| 34006759A | IN | MD | Clinical Social Worker |
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 87000659A | IN | |
| Clinical Social Worker | 1041C0700X | 34006759A | IN | Primary |
Addresses
NPPES NPI RegistryPrimary 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.