Kelly Willis, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15168 Issued in MD

Practice address

701 W Pratt St
4TH Floor
Baltimore, MD 21201-1023

Phone

(410) 328-6680

Fax

(410) 328-3806

NPI assigned

Aug 21, 2009

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

Other names 1

• Miss Kelly Dunn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1154553386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W PRATT ST",
            "address_2": "4TH FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011023",
            "telephone_number": "410-328-6680",
            "fax_number": "410-328-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W PRATT ST",
            "address_2": "4TH FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011023",
            "telephone_number": "410-328-6680",
            "fax_number": "410-328-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-21",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DUNN",
            "prefix": "MISS",
            "credential": "LCSW-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Willing to Assist
• Karen L Willing, MD
• Antonio Willingham
• Ashley Christine Willis, M.D.
• Connor Tenney Willis, MD
• Kiyana Willis, SW
• Phyllis Willis, LMSW
• Terri Anne Willis, NURSE PRACTITIONER
• Cassandra Blair Willison, PA-C
• Catherine M Willman, CRNP

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.