Courtney Kelley, LCSW

Individual provider Active NPI Clinical Social Worker · Goodview, VA

NPI 1336092162 · NPPES record last updated Apr 16, 2026

Key facts

NPI
1336092162
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
0904015152 (VA)
Practice address
2852 Morgans Mill Rd
Goodview, VA 24095-2805
Phone
(540) 676-5520
NPI assigned
Feb 19, 2026
Sex
Unspecified or another gender identity
Sole proprietor
Yes

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0904015152VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Glow Therapy, LLC Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904015152 VA Yes

Addresses

Primary practice location

2852 Morgans Mill Rd
Goodview, VA 24095-2805

Mailing address

2852 Morgans Mill Rd
Goodview, VA 24095-2805
Phone (540) 676-5520

Other providers in Goodview, VA

All providers in Goodview, VA · Clinical Social Worker in Virginia

Sources for this page

Verify at the official NPI Registry.