Kelly Ann Villmer, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PO19827 Issued in NC

Practice address

518 E 37TH St
Charlotte, NC 28205-1112

Phone

(631) 793-6649

NPI assigned

Feb 12, 2024

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1477317360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 E 37TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051112",
            "telephone_number": "631-793-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 E 37TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051112",
            "telephone_number": "631-793-6649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18151 W Catawba Ave # 15",
            "address_purpose": "LOCATION",
            "city": "Cornelius",
            "state": "NC",
            "postal_code": "280315641",
            "country_code": "US",
            "telephone_number": "704-495-4435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLMER",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "PO19827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamira Araceli Villaverde Manzur
• Eduardo Villavicencio, MSW
• Deilen Michelle Villegas, PHD, DNM, BCNP, CPD
• Rachel Rubin Villella
• James A Villier, MD FACP
• Kyle Lester Pabustan Viloria, D.D.S.
• Silviana Vina, CSFA
• Mary Beth Vincent, NURSE PRACTITIONER N
• Natalie Marion Vincent, MD
• Noah Vincent, PT, DPT

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.