Individual provider Active NPI

Sharon Michele Kelly, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1447344346
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14603 Issued in MD
Practice address
5906 Park Heights Ave
Suite 107-12
Baltimore, MD 21215-3631
Phone
(410) 236-6400
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 14603 MD Primary

Addresses

Primary practice location

5906 Park Heights Ave
Suite 107-12
Baltimore, MD 21215-3631

Mailing address

7610 Perring Ter
Baltimore, MD 21234-6121
Phone (410) 605-7365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20140811001644 MD Practitioner - Clinical Social Worker 2567689888 Practice locations: Baltimore, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5906 Park Heights Ave
Suite 107 12
Baltimore, MD 21215-3631
Phone (410) 236-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14603MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hope and Faith Counseling & Ed. Services Clinical PastSince Jan 22, 2017 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1447344346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 PERRING TER",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212346121",
            "telephone_number": "410-605-7365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5906 PARK HEIGHTS AVE",
            "address_2": "SUITE 107-12",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212153631",
            "telephone_number": "410-236-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SHARON",
        "middle_name": "MICHELE",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.