Lauren Kelly, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

11117-123 Issued in WI

Practice address

700 Rayovac Dr
Madison, WI 53711

Phone

(608) 520-0846

NPI assigned

Jul 28, 2020

Last updated

Aug 31, 2023By 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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 8, 2024 through Jan 8, 2028

Medicare enrollment (NPD)

Not 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.

• Wildflower Expressive Arts Therapies LLC

  • Mental Health Counselor
  • Madison, WI
  • NPI 1558090738
  NPD (past)

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1467061259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 RAYOVAC DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53711",
            "telephone_number": "414-801-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RAYOVAC DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53711",
            "telephone_number": "608-520-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LAUREN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "11117-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Patrick Kelly, MD
• John T Kelly, MD
• Kaitlyn J Kelly, M.D.
• Kathleen A Kelly, D.D.S.
• Kathryn Jo Kelly, RPH
• Michelle Merwood Kelly, M.D.
• Shelby Lee Kelso, APSW, SAC-IT
• Tamar R Kelson, PH.D.
• Robert Michael Kelter, LCSW
• Myra Lou Kemna, PA-C

• Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.