Kelley M Kennedy, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21285 Issued in CA

Practice address

5455 Garden Grove Blvd Ste 200
Westminster, CA 92683-8201

Phone

(562) 431-8822

NPI assigned

Oct 23, 2006

Last updated

Jun 5, 2025By the provider in NPPES

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

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.kelleykennedy@148377.advancedmd-direct.com

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.

• Pacific Coast Psychiatric Associates Inc

  dba Lifestance Health

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1265515548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14140 BEACH BLVD STE 155",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926834453",
            "telephone_number": "714-896-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 GARDEN GROVE BLVD STE 200",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926838201",
            "telephone_number": "562-431-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KELLEY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "21285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Pacheco Kay, CFNP
• KD Enterprise Holdings (KD Podiatry Group)
• Kailey Kelley, SLP-CCC
• Debra Lee Kelsey, CADC
• Mary Elizabeth Kendrick, RN
• Kimberly Kensy, PPS
• Kathleen Christen Kent, PSYD
• Victoria Kerfman
• Jaime Kerns
• Linda Nu Kes

• Clinical Social Worker in Westminster, CA
• Providers in Westminster, 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 Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.