Jordan Keyes Kellogg, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851113959 Issued in MI

Practice address

806 Tuuri PL
Flint, MI 48503-2465

Phone

(810) 767-5750

NPI assigned

Nov 14, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1636848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636848000000",
    "number": "1164188173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1569 S OGEMAW TRL",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619738",
            "telephone_number": "810-887-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 TUURI PL",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032465",
            "telephone_number": "810-767-5750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 W 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485032445",
            "country_code": "US",
            "telephone_number": "810-257-3705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "JORDAN",
        "middle_name": "KEYES",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-14",
        "last_updated": "2021-11-14",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851113959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda A Kelleghan
• Haley Keller, NP-C
• Stephanie N Keller
• Marilee Kelley
• Samantha Kellner, RN
• Gregory Kelly
• India Kelly
• Natacha Kelly
• Rochelle Marie Kelly, CHW
• Sarah Kelly, PA-C

• Clinical Social Worker in Flint, MI
• Providers in Flint, 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 Nov 14, 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.