Joanna E Kelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

073199 Issued in NY

Practice address

3251 Route 112
Building #9, Suite 2
Medford, NY 11763-1446

Phone

(631) 451-6007

Fax

(631) 732-1155

NPI assigned

Mar 23, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298332800000",
    "number": "1437276789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3251 ROUTE 112",
            "address_2": "BUILDING #9, SUITE 2",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631446",
            "telephone_number": "631-451-6007",
            "fax_number": "631-732-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 ROUTE 112",
            "address_2": "BUILDING #9, SUITE 2",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631446",
            "telephone_number": "631-451-6007",
            "fax_number": "631-732-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOANNA",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2011-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valsamma T Kandathil, MD
• Jae Kang
• John Karahalis
• Amanda Elizabeth Kearns, MS SLP
• Kelly L Keefe
• Eveleine Louise Kennedy, RN
• Melisssa Ann Kennedy, BA, MS
• Elizabeth Jane Kenney, PNP
• Kenul Chiropractic PLLC
• Dillon Kenul, DC

• Clinical Social Worker in Medford, NY
• Providers in Medford, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; 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.