Jacalyn P Kelly, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

0543871 Issued in NY

Practice address

3065 Southwestern Boulevard
Suite 204
Orchard Park, NY 14127

Phone

(716) 675-9232

Fax

(716) 675-9217

NPI assigned

Nov 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in NY

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, 1996

Medicare assignment

May accept Medicare assignment

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.

• Anthony F Bongiovanni

  • Clinical Psychologist
  • Amherst, NY
  • NPI 1003457698
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447322995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 ALBERTA DRIVE",
            "address_2": "SUITE 211",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14226",
            "telephone_number": "716-837-6705",
            "fax_number": "716-837-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 SOUTHWESTERN BOULEVARD",
            "address_2": "SUITE 204",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "14127",
            "telephone_number": "716-675-9232",
            "fax_number": "716-675-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JACALYN",
        "middle_name": "P",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "0543871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Elizabeth Kelley, M.A. CCC-SLP
• Geraldine K Kelley, M.D.
• John Joseph Kelley, OCT
• Nancy Marie Kells, CSW-R
• Grace Katherine Kelly, DNP, FNP
• Janet Elaine Kelly, OTR/L
• Kenneth J Guth MD PC
• Rochelle Kenny, MA CCC-SLP
• Jean Marie Kersten, OTR/L
• Ahmed Khattab, MD

• Social Worker in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.