Alisha Kelley

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L10710 Issued in OR

Practice address

401 NE 19TH Ave Ste 200
Portland, OR 97232-4800

Phone

(503) 358-2146

NPI assigned

May 16, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alisha Kelley LCSW,LLC

  • Clinical Social Worker
  • Portland, OR
  • NPI 1972279370
  NPD Authorized official

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1265889687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 NE 19TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972324800",
            "telephone_number": "503-358-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NE 19TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972324800",
            "telephone_number": "503-358-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "ALISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EEEIIN",
            "identifier": "871808355",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zoe Keller
• Hunter James Demers Kellerman
• Brenda Lee Kellermann, CADC1,QMHA
• Halie Sarah Kellett
• Robin Kellett, M.ED.,CAGS,LPC,LMHC
• Bonnie Kelley
• Brendan John Bach Kelley, MD
• Chawannut Kelley, RDH
• Dannah Kelley
• Erin K Kelley, HTL

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.