Kelly Ann Belczyk, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L5440 Issued in OR

Practice address

1128 NW Harriman St
Bend, OR 97701-1947

Phone

(541) 330-4637

Fax

(541) 330-4642

NPI assigned

Feb 5, 2010

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

Medicare fee-for-service enrollment

Enrolled in OR

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deschutes County OregonGroup PAC ID 9638083371, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Deschutes County Oregon

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bend, OR
  • NPI 1235172180
  Medicare reassignment Care Compare group NPD
• Kelly Belczyk LCSW LLC

  • Clinical Social Worker
  • Bend, OR
  • NPI 1265237432
  NPD Authorized official
• Deschutes County Oregon

  • Addiction (Substance Use Disorder) Counselor
  • Bend, OR
  • NPI 1366656068
  NPD
• Deschutes County Oregon

  • Health Educator
  • Bend, OR
  • NPI 1598323040
  NPD

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1548592298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 NE 10TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977015142",
            "telephone_number": "541-317-3173",
            "fax_number": "541-330-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 NW HARRIMAN ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977011947",
            "telephone_number": "541-330-4637",
            "fax_number": "541-330-4642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "165 NE 10th St",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977015142",
            "country_code": "US",
            "telephone_number": "541-728-3029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELCZYK",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L5440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Bedoian, LMT
• Lauren Kay Beebe, PA-C
• Makenna Beeson
• Sharole Beisenherz, CADC I
• Elena Katherina Beitzel
• Deanna Faith Bell, LMT, CYI
• Hannah Bell
• Heather Bell
• Keith William Bell, PA
• Michael L Bell, M.D.

• Clinical Social Worker in Bend, OR
• Providers in Bend, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.
• 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.