Kelvin Banegas, LCSW

Individual provider Active NPI Clinical Social Worker · Bayville, NJ

NPI 1194415489 · NPPES record last updated Oct 23, 2025

Key facts

NPI
1194415489
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SC06503700 (NJ)
Practice address
19 Prairie LN
Bayville, NJ 08721-2249
Phone
(516) 469-2135
NPI assigned
May 10, 2023
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19 Prairie LN
Bayville, NJ 08721-2249
Phone (516) 469-2135

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20251222003337 NJ Practitioner - Clinical Social Worker 2062907561 Practice locations: Bayville, NJ

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
44SC06503700NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kelvin Banegas LCSW LLC Mental Health Current
since May 14, 2023
Accepting new patients
Letapel Inc. Clinical Past
since May 1, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC06503700 NJ Yes

Addresses

Primary practice location

19 Prairie LN
Bayville, NJ 08721-2249

Mailing address

19 Prairie LN
Bayville, NJ 08721-2249
Phone (516) 469-2135

Other providers in Bayville, NJ

All providers in Bayville, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.