Active NPI
Melissa Rose Kelly, LICSW
- Clinical Social Worker
- Plymouth, MA
National Provider Identifier
1578081733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 122884
- Practice address
- 148 Industrial Park Rd
Plymouth, MA 02360-7243 - Phone
- (508) 746-5900
- NPI assigned
- Sep 7, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 122884 | MA | Primary |
Addresses
Primary practice location
148 Industrial Park Rd
Plymouth, MA 02360-7243
Mailing address
148 Industrial Park Rd
Plymouth, MA 02360-7243
Phone (508) 746-5900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122884 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692662400000",
"number": "1578081733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 INDUSTRIAL PARK RD",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023607243",
"telephone_number": "508-746-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 INDUSTRIAL PARK RD",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023607243",
"telephone_number": "508-746-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MELISSA",
"middle_name": "ROSE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-07",
"last_updated": "2023-08-22",
"certification_date": "2023-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "122884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.