NPIMap

Organization Active NPI

Loretta Kelly LCSW PC

  • Clinical Social Worker
  • Copiague, NY
National Provider Identifier
1376201285
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LORETTA KELLY LCSW PC
Practice address
250 Beachview St
Copiague, NY 11726-3604
Phone
(631) 805-5668
NPI assigned
Dec 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Loretta Kelly, LCSWNPI 1962955088
Title
Owner
Phone
(631) 805-5668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

250 Beachview St
Copiague, NY 11726-3604

Mailing address

250 Beachview St
Copiague, NY 11726-3604
Phone (631) 805-5668

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1376201285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BEACHVIEW ST",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117263604",
            "telephone_number": "631-805-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BEACHVIEW ST",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117263604",
            "telephone_number": "631-805-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORETTA KELLY LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-805-5668",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Copiague, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.