Individual provider Active NPI

Kerry Katherine Kelly, MSW

  • Clinical Social Worker
  • West Haven, CT
National Provider Identifier
1306938121
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
114 Boston Post Rd
Errera Community Care Center
West Haven, CT 06516-2043
Phone
(203) 640-6637
Fax
(203) 931-4068
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 Primary

Addresses

Primary practice location

114 Boston Post Rd
Errera Community Care Center
West Haven, CT 06516-2043

Mailing address

114 Boston Post Rd
Errera Community Care Center
West Haven, CT 06516-2043
Phone (203) 640-6637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306938121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 BOSTON POST RD",
            "address_2": "ERRERA COMMUNITY CARE CENTER",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162043",
            "telephone_number": "203-640-6637",
            "fax_number": "203-931-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BOSTON POST RD",
            "address_2": "ERRERA COMMUNITY CARE CENTER",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162043",
            "telephone_number": "203-640-6637",
            "fax_number": "203-931-4068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KERRY",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.