Kelly Taylor, LADC, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9915 Issued in CT

Practice address

9 Covey Rd
2Af
Burlington, CT 06013-1720

Phone

(860) 259-4442

NPI assigned

Feb 2, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Catalyst Counseling of Connecticut

  • Professional Counselor
  • Burlington, CT
  • NPI 1043684145

  Addiction (Substance Use Disorder)

  NPD (past) Authorized official

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508224858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 COVEY RD",
            "address_2": "2AF",
            "city": "BURLINGTON",
            "state": "CT",
            "postal_code": "060131720",
            "telephone_number": "860-259-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 COVEY RD",
            "address_2": "2AF",
            "city": "BURLINGTON",
            "state": "CT",
            "postal_code": "060131720",
            "telephone_number": "860-259-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KELLY",
        "credential": "LADC, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "1166",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008067986",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Sue Schrader, PH.D.
• David Paley Schwaber, D.D.S
• Smile Haven Dental Center II
• Karen Marie Sullivan, M.A.
• Madison Alexis Swartout, DPT
• Jeanne Theleen, LPC
• Therapeutic Counseling Center of Connecticut
• Tonucci Therapy, LLC
• Michael Tonucci, LPC-A, BCBA, LBA
• Tranquil Beginnings LLC

• All providers in Burlington, CT
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.