Active NPI
Kelly A Walch, LCSW
- Clinical Social Worker
- Tempe, AZ
National Provider Identifier
1497314918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-17116
- Practice address
- 209 E Baseline Rd
Ste E102 #2
Tempe, AZ 85283-1299 - Phone
- (215) 850-5397
- NPI assigned
- Jun 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-17116 | AZ | Primary |
Addresses
Primary practice location
209 E Baseline Rd
Ste E102 #2
Tempe, AZ 85283-1299
Mailing address
827 W Malibu Dr
Tempe, AZ 85282-4739
Phone (215) 850-5397
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 1, 2025 through Feb 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-17116 | AZ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559952000000",
"number": "1497314918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "827 W MALIBU DR",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852824739",
"telephone_number": "215-850-5397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 E BASELINE RD",
"address_2": "STE E102 #2",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852831299",
"telephone_number": "215-850-5397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALCH",
"first_name": "KELLY",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-08",
"last_updated": "2019-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LCSW-17116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2019; 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.