Robert Charles Kelly, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R026496-1 Issued in NY

Practice address

984 N Broadway
Suite Number 411
Yonkers, NY 10701-1318

Phone

(914) 963-6068

NPI assigned

Jul 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Clinical Social Worker

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Counseling Psychology, PC

  • Clinical Psychologist
  • Yonkers, NY
  • NPI 1558323295
  NPD (past)

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508064924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 FARRAGUT AVE",
            "city": "HASTINGS ON HUDSON",
            "state": "NY",
            "postal_code": "107063519",
            "telephone_number": "914-963-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 N BROADWAY",
            "address_2": "SUITE NUMBER 411",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011318",
            "telephone_number": "914-963-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R026496-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "174852",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02261521",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "080064",
            "identifier": "VALUE OPTIONS",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0076246",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clare Bridget Kelly, R.N.
• Linda Bridget Kelly
• Michael Foster Kelly, L.AC.
• Michael Francis Kelly, R.N., MS, PNP
• Michael Thomas Kelly, LMSW
• James N Kelso, PHARM D.
• Madelon Kendricks, LCSW
• Kenneth Braunstein
• Margaret Kenny
• Nai Keowongwan-Coon, RPH

• Clinical Social Worker in Yonkers, NY
• Providers in Yonkers, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.