Mason Louis Kelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149011810 Issued in IL

Practice address

8553 S Stony Island Ave
FL 1
Chicago, IL 60617-2249

Phone

(773) 972-3577

Fax

(872) 666-5512

NPI assigned

Dec 28, 2006

Last updated

Dec 1, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• D Gordon & Associates LLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1215431333
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1396801064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8553 S STONY ISLAND AVE",
            "address_2": "FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172249",
            "telephone_number": "773-972-3577",
            "fax_number": "872-666-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8553 S STONY ISLAND AVE",
            "address_2": "FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172249",
            "telephone_number": "773-972-3577",
            "fax_number": "872-666-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MASON",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Kelly
• Margaret Kelly, OTR
• Mary Kelly, LCSW
• Mary Farrington Kelly, LCSW
• Maryann Valentine Kelly, D.D.S.
• Matthew Kelly, MD
• Matthew C Kelly, PHARMD
• Maureen Kelly, DO
• Maureen R. Kelly, MSW, LCSW
• Meghan Kelly, MSN, RN, AGACNP-BC

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.