Charles Kellerman, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

108591-01 Issued in NY

Practice address

50 W Hawthorne Ave
Valley Stream, NY 11580-6223

Phone

(516) 569-6600

NPI assigned

Jan 13, 2025

Sex

Male

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": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1255141941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W HAWTHORNE AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115806223",
            "telephone_number": "718-845-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W HAWTHORNE AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115806223",
            "telephone_number": "516-569-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLERMAN",
        "first_name": "CHARLES",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "108591-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayodele Kayode
• Irina Kazanskaya
• Syed Sohaib Kazim, PHARMACIST
• Kekeli Counseling Services LLC
• Anne Keleman, M.S.
• Geraldine M Kelly, NURSE PRACTITIONER
• Tamisha Kelly, PMHNP
• Florence Kema-Akpala, RN
• Jessica Ann Kennedy, D.C.
• Ruby Puneet Kesar, MD

• Clinical Social Worker in Valley Stream, NY
• Providers in Valley Stream, 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 Jan 13, 2025; 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.