Laurel C Kelso, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00007524 Issued in WA

Practice address

7191 Wagner Way
Suite 301
Gig Harbor, WA 98335-0115

Phone

(253) 514-8076

Fax

(253) 514-8078

NPI assigned

Feb 2, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Crescent Psychiatry PLLC

  • Clinical Psychologist
  • Lakewood, WA
  • NPI 1245462134
  NPD (past)

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1245478064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97115",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984970115",
            "telephone_number": "253-588-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7191 WAGNER WAY",
            "address_2": "SUITE 301",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983350115",
            "telephone_number": "253-514-8076",
            "fax_number": "253-514-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSO",
        "first_name": "LAUREL",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-02",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00007524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL  LICENSE",
            "identifier": "LW00007524",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colleen Patricia Kelly
• Kaitlin M Kelly, PA-C
• Lisa H Kelly, PT
• Kelsey Roth Counseling Services, PLLC
• Kelsey Weiland LMP
• Tonja Lynn Kendrick, LMFT
• Michael Kenner, PAC
• Nicole Kent, PHD, RN
• Key Nephrology, PLLC
• Wajahat Ali Khan, M.D.

• Clinical Social Worker in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; 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.