Active NPI
Kelly Marie Justice
- Clinical Social Worker
- Georgetown, KY
National Provider Identifier
1427315399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 253167
- Practice address
- 100 Wishing Well Path Apt 2308
Georgetown, KY 40324-2185 - Phone
- (859) 429-2131
- NPI assigned
- Apr 17, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 253167 | KY | Primary |
Addresses
Primary practice location
100 Wishing Well Path Apt 2308
Georgetown, KY 40324-2185
Mailing address
100 Wishing Well Path Apt 2308
Georgetown, KY 40324-2185
Phone (859) 429-2131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 253167 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710374400000",
"number": "1427315399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WISHING WELL PATH APT 2308",
"city": "GEORGETOWN",
"state": "KY",
"postal_code": "403242185",
"telephone_number": "859-429-2131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WISHING WELL PATH APT 2308",
"city": "GEORGETOWN",
"state": "KY",
"postal_code": "403242185",
"telephone_number": "859-429-2131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUSTICE",
"first_name": "KELLY",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-17",
"last_updated": "2024-03-14",
"certification_date": "2024-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "253167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.