Corey R Kelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

218996 Issued in MA

Practice address

450 Washington St
Dedham, MA 02026-4455

Phone

(617) 329-0909

NPI assigned

Sep 6, 2013

Sex

Female

Sole proprietor

No

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, last updated by the provider on Sep 6, 2013.

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1487089694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 WASHINGTON ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WASHINGTON ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264455",
            "telephone_number": "617-329-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "COREY",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "218996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nourhan Katry
• Cheryl Kaufmann, LMHC
• Lauren Elizabeth Keating, PA-C
• Joanne Keaveney, R.D.
• Rose Kelleher
• Sean Patrick Kelly, PA-C
• Kenneth Goodman DMD Nathan Goodman DMD PC
• Jillian Kermin
• Regine Kersaint Kersaint
• Myra Khawar, DO

• All providers in Dedham, MA
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; 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.