Maureen Kelly, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3936 Issued in MN

Practice address

977 Summit Ave
Saint Paul, MN 55105-3032

Phone

(651) 227-6369

NPI assigned

Nov 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charles McCafferty, MD, LLC

  • Adult Mental Health Clinic/Center
  • Saint Paul, MN
  • NPI 1003094731
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255403838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 SUMMIT AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053032",
            "telephone_number": "651-227-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 SUMMIT AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053032",
            "telephone_number": "651-227-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MAUREEN",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "3936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Rae Kelly, PA-C
• Candice Marie Kelly, RN
• Jody Lehua Kelly, CCC-SLP
• Kevin Patrick Kelly, MSW
• Laura Kelly, LGSW
• Peter H Kelly, MD
• Steven Robert Kelly
• Tara Lee Kelly, MD
• Rachel Kay Kelm, PA-C
• Kelove Carruthers Inc (House Of Love Community Resources)

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.