Kelly Anne Mangiafico, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

DP00947067 Issued in WV

Practice address

175 Philpott LN
Beaver, WV 25813-9501

Phone

(304) 254-9262

NPI assigned

Jan 9, 2007

Last updated

Jul 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Kelly Anne Johnson Former name

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: No
• 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

Practice roles

Locations

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

• Rushford Center, Inc.

  • Psychologist
  • Meriden, CT
  • NPI 1275541005

  Clinical

  Medicare reassignment NPD
• Hartford Dispensary

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hartford, CT
  • NPI 1104949973
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1538218805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 PHILPOTT LN",
            "city": "BEAVER",
            "state": "WV",
            "postal_code": "258139501",
            "telephone_number": "304-254-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 PHILPOTT LN",
            "city": "BEAVER",
            "state": "WV",
            "postal_code": "258139501",
            "telephone_number": "304-254-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIAFICO",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "8037",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00947067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "JOHNSON",
            "middle_name": "ANNE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Linkous Family Health Care LLC
• Allery Lockridge, MASTERS
• Jamie Suzanne Lowery
• M I Dababnah MD Inc
• Miranda Brooke Maddox
• Mary E McKelvey, MD
• Barbara McKinney
• Dominick Harry McLain, D.O,
• Ashley Nichole McMillion, LPN
• Alison Meade

• Clinical Social Worker in Beaver, WV
• Providers in Beaver, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.