Colleen Kelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

097696 Issued in NY

Practice address

7701 13TH Ave
Brooklyn, NY 11228-2413

Phone

(182) 321-3517

NPI assigned

Sep 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Fordham University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aspire Medical Care Services PCGroup PAC ID 6204379605, 4 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.

• Aspire Medical Care Services PC

  • Multi-Specialty Clinic/Center
  • Levittown, NY
  • NPI 1346007895
  Medicare reassignment Care Compare group NPD
• Valera Medical, P.C.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1437782349

  Social Worker

  Medicare reassignment NPD
• National Neighborhood Counseling Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn, NY
  • NPI 1457352098
  NPD

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1205440591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 13TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282413",
            "telephone_number": "182-321-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 13TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282413",
            "telephone_number": "182-321-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "COLLEEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "110092",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rendel Kellum
• Amelia Gale Kelly, MD
• Anne B. Kelly, LMSW
• Cathyann Kelly
• Christopher Paul Kelly, MD
• Deidra Kelly
• Elizabeth Kelly, B.A SP ED.
• Filberto Kelly, MD
• Guy Kelly, P.A.
• Heather M. Kelly, LCSW

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.