Active NPI
Dorothea Sandra Kelly, MSW, LCSW
- Clinical Social Worker
- Cherry Hill, NJ
National Provider Identifier
1326150756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SC00039100
- Practice address
- 496 Kings Hwy N
Suite 223
Cherry Hill, NJ 08034-1017 - Phone
- (856) 482-2477
- Fax
- (856) 415-0336
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC00039100 | NJ | Primary |
Addresses
Primary practice location
496 Kings Hwy N
Suite 223
Cherry Hill, NJ 08034-1017
Mailing address
496 Kings Hwy N
Suite 223
Cherry Hill, NJ 08034-1017
Phone (856) 482-2477
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2235656000 | Other | PA | IBC |
| 4504459 | Other | PA | AETNA |
Other names 1
- Ms. Sandy Kelly
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC00039100 | NJ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family & Psychological Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Cherry Hill, NJ
- NPI 1477930816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326150756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "496 KINGS HWY N",
"address_2": "SUITE 223",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080341017",
"telephone_number": "856-482-2477",
"fax_number": "856-415-0336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "496 KINGS HWY N",
"address_2": "SUITE 223",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080341017",
"telephone_number": "856-482-2477",
"fax_number": "856-415-0336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "DOROTHEA",
"middle_name": "SANDRA",
"name_prefix": "Ms.",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC00039100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBC",
"identifier": "2235656000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4504459",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SANDY",
"last_name": "KELLY",
"prefix": "MS.",
"credential": "MSW, LCSW",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Cherry Hill, NJ
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.