Kelly Kohli, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10371882-3501 Issued in UT

Practice address

1544 Woodland Park Dr Ste 320
Layton, UT 84041-5621

Phone

(801) 556-4751

NPI assigned

May 13, 2014

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

Other names 1

• Kelly Goodrich Former name

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Davis Psychological ServicesGroup PAC ID 0446511927, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• South Davis Psychological Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Centerville, UT
  • NPI 1386142396

  UT

  Medicare reassignment Care Compare group NPD
• Neurorev PLLC

  • Physical Therapy Clinic/Center
  • Centerville, UT
  • NPI 1598229155
  NPD

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1265843205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 N 2125 W",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840412104",
            "telephone_number": "801-556-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1544 WOODLAND PARK DR STE 320",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415621",
            "telephone_number": "801-556-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLI",
        "first_name": "KELLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10371882-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "GOODRICH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Teighlor Kodel
• Linda Koenen, NP
• Teresa Koerner
• Kenneth R. Kofoed, M.D.
• Jessica Kohler
• Noel E. Koons, M.S., ACMHC
• Elizabeth Stayner Kopaigora, LCSW
• Aimee Dainelle Koryta, RN
• Heather Krambule, APRN
• Frank D Kramer, MD

• All providers in Layton, UT
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.