Individual provider Active NPI

Kelsey Spivey, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1174124416
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8304-C Issued in NV
Practice address
5426 Vegas Dr
Las Vegas, NV 89108-2403
Phone
(702) 806-5268
NPI assigned
Nov 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8304-C NV Primary

Addresses

Primary practice location

5426 Vegas Dr
Las Vegas, NV 89108-2403

Mailing address

10463 Skye Canyon Falls Ave
Las Vegas, NV 89166-1208
Phone (702) 283-9988

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8304-CNVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1174124416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10463 SKYE CANYON FALLS AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891661208",
            "telephone_number": "702-283-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5426 VEGAS DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891082403",
            "telephone_number": "702-806-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVEY",
        "first_name": "KELSEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "8304-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.