Lisa M. Kelly, MSW, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1502427 Issued in OH

Practice address

2708 Cleveland Rd Ste 200
Wooster, OH 44691-1703

Phone

(234) 249-2189

NPI assigned

Jun 17, 2013

Reactivated

Dec 18, 2014

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

Other names 1

• Lisa M Herald Former name

Medicare fee-for-service enrollment

Enrolled in OH

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, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Roads of Change Counseling, LLC

  • Clinical Social Worker
  • Wooster, OH
  • NPI 1639926603
  Medicare reassignment NPD Authorized official
• Catholic Charities Corporation

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Euclid, OH
  • NPI 1972550010
  Medicare reassignment NPD

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1437598182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 BEALL AVE",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913589",
            "telephone_number": "234-249-2189",
            "fax_number": "330-262-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 CLEVELAND RD STE 200",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911703",
            "telephone_number": "234-249-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LISA",
        "middle_name": "M.",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "deactivation_date": "2014-01-21",
        "reactivation_date": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "1502427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "HERALD",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deborah M Keller
• Jill Nicole Keller, MSSA, LSW
• Ellen Marie Kelly, PA-C
• Gail Lynne Kelly
• K. Michelle Kelly, LSW, LPCC
• Michaela Kelly
• Martyne C Kempel, LISW
• Olivia Joy Kendall
• Artavia Kennebrew
• Keandre Jamaal Kennebrew

• Clinical Social Worker in Wooster, OH
• Providers in Wooster, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.