Kelly Tejada, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904011780 Issued in VA

Practice address

19 E Market St
Leesburg, VA 20176-3004

Phone

(703) 727-2544

NPI assigned

Feb 24, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Kelly G Calvert Former name

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.

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1508306598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 COLESVILLE RD.",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "20901",
            "telephone_number": "240-206-1358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E MARKET ST",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763004",
            "telephone_number": "703-727-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJADA",
        "first_name": "KELLY",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-24",
        "last_updated": "2022-09-06",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "22265",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50082678",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CALVERT",
            "middle_name": "G",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Swetha Tanguturi, M.D.
• Sarah Elizabeth Tarter, CNM
• Alexander J Taylor, MSW
• James Albert Taylor Jr., DVM
• Monica Andrea Taylor, LPC
• Vincent Terreri, MS
• Amanda Lee Thacker, FNP
• Huong Ngoc Thai-Kemprowski, M.D.
• Ashley M Thalacker, FNP-BC
• Muskan Thapa

• Clinical Social Worker in Leesburg, VA
• Providers in Leesburg, VA by specialty
• Clinical Social Worker in Virginia

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