Michelle R Kelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7061940-3501 Issued in UT

Practice address

10459 S Temple Dr Ste 102
South Jordan, UT 84095-8930

Phone

(801) 432-0778

NPI assigned

Feb 20, 2024

Sex

Female

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

Enrolled in UT, WI, IL, NJ4 enrollments

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.

Enrollment records 4

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

BMSC Az LLCGroup PAC ID 4385929173, 130 clinicians

Blue Moon Senior Counseling of Illinois LLCGroup PAC ID 7012172893, 30 clinicians

Joyful Living Counseling PLLCGroup PAC ID 1557710514, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Joyful Living Counseling PLLC

  • Clinical Social Worker
  • Riverton, UT
  • NPI 1679347280
  Medicare reassignment Care Compare group NPD
• Blue Moon Senior Counseling of Illinois LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1841562931
  Medicare reassignment Care Compare group NPD
• BMSC Az LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1497201875

  NJ, UT, WI

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1184489924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10459 S TEMPLE DR STE 102",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958930",
            "telephone_number": "801-432-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10459 S TEMPLE DR STE 102",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958930",
            "telephone_number": "801-432-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "7061940-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Kehler
• Joseph Keller
• Sarah Richele Kelley
• Stephanie Church Kelley, ACMHC
• Christopher P Kelly, MD
• Aidan Kemp
• Katherine Ann Kennedy
• Laura Rice Kenney, APRN
• Russell Kennington
• Jessica Kent

• Clinical Social Worker in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.