Individual provider Active NPI

Carolyn Kelly-Jones, LCSW

  • Clinical Social Worker
  • Bastrop, LA
National Provider Identifier
1255470837
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3573 Issued in LA
Practice address
402 Highland Ave
Bastrop, LA 71220-2241
Phone
(318) 239-3857
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3573 LA Primary

Addresses

Primary practice location

402 Highland Ave
Bastrop, LA 71220-2241

Mailing address

PO Box 792
Bastrop, LA 71221-0792
Phone (318) 239-8015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20070809000219 LA Practitioner - Clinical Social Worker 9931290673 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Morehouse Community Medical Centers, Inc. CurrentSince May 6, 2020 Accepting new patients
Morehouse Community Medical Centers, Inc. CurrentSince May 6, 2020 Accepting new patients
Immanuels Healing Center Past Accepting new patients
Patricia Bell Past Accepting new patients

Locations

518 Durham St
Bastrop, LA 71220
Phone (318) 556-3333

402 Highland Ave
Bastrop, LA 71220
Phone (318) 239-3883

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1255470837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 792",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712210792",
            "telephone_number": "318-239-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 HIGHLAND AVE",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712202241",
            "telephone_number": "318-239-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY-JONES",
        "first_name": "CAROLYN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "3573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, LA

Sources for this page

Verify at the official NPI Registry.