Individual provider Active NPI

Kelly Louise Murrell, LCSW

  • Clinical Social Worker
  • Rochester, NY
National Provider Identifier
1205124740
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082070 Issued in NY
Practice address
1645 St. Paul Street
Rochester, NY 14621-1455
Phone
(585) 546-7220
Fax
(585) 232-5703
NPI assigned
Jul 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 081346 NY
Clinical Social Worker 1041C0700X 082070 NY Primary

Addresses

Primary practice location

1645 St. Paul Street
Rochester, NY 14621-1455

Mailing address

1645 St. Paul Street
Rochester, NY 14621-1455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140911002070 NY Practitioner - Clinical Social Worker 6800015546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Charities of the Diocese of RochesterGroup PAC ID 0345334272, 11 clinicians

Practice addresses (Care Compare)

79 N Clinton Ave
Rochester, NY 14604-1407
Phone (585) 546-7220

87 N Clinton Ave
Rochester, NY 14604-1407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082070NYMDClinical Social Worker
081346NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of the Diocese of Rochester CurrentSince Jul 1, 2014 Accepting new patients

Locations

79 N Clinton Ave
Rochester, NY 14604
Phone (585) 546-3046

1645 Saint Paul St
Rochester, NY 14621
Phone (585) 546-3046

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1205124740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 ST. PAUL STREET",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146211455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 ST. PAUL STREET",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146211455",
            "telephone_number": "585-546-7220",
            "fax_number": "585-232-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRELL",
        "first_name": "KELLY",
        "middle_name": "LOUISE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081346",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.