Rachel Kelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW007289 Issued in GA

Practice address

511 Silver Lake Rd
Bainbridge, GA 39817-6849

Phone

(229) 254-0661

NPI assigned

May 3, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1417530965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 SILVER LAKE RD",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398176849",
            "telephone_number": "229-254-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 SILVER LAKE RD",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398176849",
            "telephone_number": "229-254-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "RACHEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17480",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• K and K Living, LLC
• Jordan Rae Kay, M.ED. CCC-SLP
• Charsuede Keaton
• Kathryn Harrell Kelley, SLP
• Wesley Kyle Kelley, NP
• Themiah Shafaye Kendrick
• Beth Killough
• Laquanda Renee King
• Atoria Danielle Kirksey, ARNP
• Carlson Kububu

• Clinical Social Worker in Bainbridge, GA
• Providers in Bainbridge, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.