Active NPI
Kelly Sue Van Gelder, LISW
- Clinical Social Worker
- Rock Valley, IA
National Provider Identifier
1356518518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 03604
- Practice address
- 1905 10TH St
Rock Valley, IA 51247-1630 - Phone
- (712) 476-5245
- Fax
- (712) 476-9621
- NPI assigned
- May 15, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 03604 | IA | Primary |
Addresses
Primary practice location
1905 10TH St
Rock Valley, IA 51247-1630
Mailing address
PO Box 163
Rock Valley, IA 51247-0163
Phone (712) 476-5245
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03604 | IA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creative Living Center, P.C. | Clinical | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210809600000",
"number": "1356518518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 163",
"city": "ROCK VALLEY",
"state": "IA",
"postal_code": "512470163",
"telephone_number": "712-476-5245",
"fax_number": "712-476-9621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 10TH ST",
"city": "ROCK VALLEY",
"state": "IA",
"postal_code": "512471630",
"telephone_number": "712-476-5245",
"fax_number": "712-476-9621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN GELDER",
"first_name": "KELLY",
"middle_name": "SUE",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-15",
"last_updated": "2008-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "03604",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Valley, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.