Kelly Luce Acevedo

Individual provider Active NPI Social Worker · Peachtree City, GA

NPI 1588080600 · NPPES record last updated Mar 13, 2014

Key facts

NPI
1588080600
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
MSW005370 (GA)
Practice address
111 Petrol PT
Suite H
Peachtree City, GA 30269-1550
Phone
(470) 296-1841
NPI assigned
Mar 13, 2014
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MSW005370GAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly Luce Acevedo Social Worker Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MSW005370 GA Yes

Addresses

Primary practice location

111 Petrol PT
Suite H
Peachtree City, GA 30269-1550

Mailing address

117 Holly Springs Dr
Peachtree City, GA 30269-3045
Phone (470) 296-1841

Other providers in Peachtree City, GA

All providers in Peachtree City, GA · Social Worker in Georgia

Sources for this page

Verify at the official NPI Registry.