Angel Rene Kelly-Blaydes, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS11623 Issued in CA

Practice address

1500 S McDonnell Ave
Los Angeles, CA 90040-5623

Phone

(323) 981-4308

Fax

(323) 269-2541

NPI assigned

Nov 14, 2006

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1235201385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S MCDONNELL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900405623",
            "telephone_number": "323-981-4308",
            "fax_number": "323-269-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MCDONNELL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900405623",
            "telephone_number": "323-981-4308",
            "fax_number": "323-269-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY-BLAYDES",
        "first_name": "ANGEL",
        "middle_name": "RENE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS11623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Polly Durant Kellner, OTR/L
• Alexander J Kellogg, PHARMD
• Toni Sue Kells, AMFT, LAADC
• Antoinette Kellum
• Kelly Ho, D.D.S.
• Samantha Kelly-Latzer
• Alison Scott Kelly, M.S., R.D.
• Aubrey Derrick Kelly
• Brenna Michelle Kelly
• Carol Ann Kelly, ED.D.

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.