Kellyn Lacey Ishman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW025746 Issued in PA

Practice address

1215 Manor Dr Ste 209
Mechanicsburg, PA 17055-4936

Phone

(717) 790-1700

NPI assigned

Dec 9, 2022

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Be Better Utah

  • Mental Health Counselor
  • Bountiful, UT
  • NPI 1154051167
  NPD
• Valley Counseling Center

  • Marriage & Family Therapist
  • Mechanicsburg, PA
  • NPI 1174173504

  Clinical

  NPD (past)

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1316658446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 E PORTLAND ST",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170553349",
            "telephone_number": "717-798-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 MANOR DR STE 209",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554936",
            "telephone_number": "717-790-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHMAN",
        "first_name": "KELLYN",
        "middle_name": "LACEY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW025746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Ickes
• Carter A. Innerst, DPT
• Insightful Growth Counseling LLC
• Inspired Physical Therapy LLC
• Integrated Medical Transport LLC
• Agnes Itunga
• J&J Jireh Health Services LLC
• Ja Alba LLC
• Bray Thomas Jackson, DPT
• Marcia Blaire Jackson

• Clinical Social Worker in Mechanicsburg, PA
• Providers in Mechanicsburg, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.