Michelle Kelly, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

38 Sisson Road
Unit 202
Harwich Port, MA 02646

Phone

(774) 269-6229

Fax

(508) 437-8118

NPI assigned

Jul 15, 2016

Last updated

Jan 19, 2022By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Coastal Cape Counseling, LLC

  • Clinical Social Worker
  • Harwich Port, MA
  • NPI 1033876818
  NPD Authorized official

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1306299219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 GRAY BIRCH ROAD",
            "city": "EAST SANDWICH",
            "state": "MA",
            "postal_code": "02537",
            "telephone_number": "774-269-6229",
            "fax_number": "508-437-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 SISSON ROAD",
            "address_2": "UNIT 202",
            "city": "HARWICH PORT",
            "state": "MA",
            "postal_code": "02646",
            "telephone_number": "774-269-6229",
            "fax_number": "508-437-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MICHELLE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Iacovino, BSN, MS, AGPCNP-BC
• Kimberly Anne Irvine, FNP-C
• Caitlin Rebecca Jackson, LCSW
• Sarah F. Johnson, FNP
• Stephanie Jordan
• Adria Marie Kennedy, PMHNP-BC
• Kelly King, MD
• Brian Koll, MD
• Anthony Kyriakides
• Marian D Lalevee, MS RD CDE LDN

• Clinical Social Worker in Harwich Port, MA
• Providers in Harwich Port, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.