Individual provider Active NPI

Jacquelyn Kellett, LCSW

  • Clinical Social Worker
  • Marrero, LA
National Provider Identifier
1326400797
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11616 Issued in LA
Practice address
1855 Ames Blvd
Marrero, LA 70072-3429
Phone
(504) 214-0072
NPI assigned
Mar 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2016

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 11616 LA Primary

Addresses

Primary practice location

1855 Ames Blvd
Marrero, LA 70072-3429

Mailing address

1825 Hope St
New Orleans, LA 70119-1307
Phone (504) 952-3658

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

LicenseStateTypeSpecialty
11616LAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1326400797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 HOPE ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701191307",
            "telephone_number": "504-952-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 AMES BLVD",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723429",
            "telephone_number": "504-214-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLETT",
        "first_name": "JACQUELYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "11616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; 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.