Charles B. Kellam, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

047627-1 Issued in NY

Practice address

1727 Amsterdam Ave
New York, NY 10031-4611

Phone

(212) 694-9200

Fax

(212) 368-5608

NPI assigned

Nov 29, 2006

Sex

Male

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

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487721932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PARK TER E APT 5E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341559",
            "telephone_number": "212-304-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100314611",
            "telephone_number": "212-694-9200",
            "fax_number": "212-368-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAM",
        "first_name": "CHARLES",
        "middle_name": "B.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "047627-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela Elisabeth Kelaghan Kaliner, LMSW
• Hope Kelaher, LCSW
• Eric R Kelhoffer, MD
• Shira Kelin, PSYD
• Janhawi Kelkar
• Tavoria Kellam, MW
• Lucia Kellar, PH.D.
• Andrew Kelleher, MD
• Catherine Kelleher
• Christine Kelleher

• Clinical Social Worker in New York, NY
• Providers in New York, 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 Jul 8, 2007; 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.