Individual provider Active NPI

Kellee Kalfass, LCSW

  • Clinical Social Worker
  • East Syracuse, NY
National Provider Identifier
1336442367
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
075485 Issued in NY
Practice address
5900 N Burdick St
Ste 100a
East Syracuse, NY 13057-9463
Phone
(315) 671-2867
NPI assigned
Dec 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 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 075485 NY Primary

Addresses

Primary practice location

5900 N Burdick St
Ste 100a
East Syracuse, NY 13057-9463

Mailing address

6048 Jerusalem Dr
Cicero, NY 13039-8885
Phone (315) 247-8094

Other names 1

  • Kellee Powell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110503000119 NY Practitioner - Clinical Social Worker 5597940718 Practice locations: East Syracuse, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5900 N Burdick St
Suite 100a
East Syracuse, NY 13057-9463
Phone (315) 247-8094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
075485NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1336442367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6048 JERUSALEM DR",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130398885",
            "telephone_number": "315-247-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 N BURDICK ST",
            "address_2": "STE 100A",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579463",
            "telephone_number": "315-671-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALFASS",
        "first_name": "KELLEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-14",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEE",
            "last_name": "POWELL",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.