Kelly Christin Gulling-Dejoe, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R0737551 Issued in NY

Practice address

1 Lockwood Drive #210
Pittsford, NY 14534

Phone

(585) 586-0240

Fax

(585) 586-0261

NPI assigned

Apr 14, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1467626192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LOCKWOOD DRIVE #210",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "14450",
            "telephone_number": "585-586-0240",
            "fax_number": "585-586-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LOCKWOOD DRIVE #210",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "14534",
            "telephone_number": "585-586-0240",
            "fax_number": "585-586-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLING-DEJOE",
        "first_name": "KELLY",
        "middle_name": "CHRISTIN",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-14",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R073755",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0737551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Salvatore Guarnieri, DDS
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• P. Elisabeth Hager, MD
• Cathy Hahn, M.D.
• Mona Haleem, D.D.S
• Lynne G Halik, D.D.S.

• Clinical Social Worker in Pittsford, NY
• Providers in Pittsford, 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 Jan 30, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.