Kelly Kristina Kolodziejski, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

083431 Issued in NY

Practice address

916 Old Liverpool Rd Ste B
Liverpool, NY 13088-8536

Phone

(315) 743-4042

NPI assigned

Feb 9, 2012

Last updated

May 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kelly Kolodziejski LCSW R

  • Clinical Social Worker
  • Liverpool, NY
  • NPI 1194382127
  NPD (past) Authorized official

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1598038374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 OLD LIVERPOOL RD STE B",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130888536",
            "telephone_number": "315-743-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 OLD LIVERPOOL RD STE B",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130888536",
            "telephone_number": "315-743-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODZIEJSKI",
        "first_name": "KELLY",
        "middle_name": "KRISTINA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph L Kinsley, RPA
• Jessica Kish
• Steven Anthony Klink, DC
• Samantha Marie Knapp
• Daisy Dawoon Ko, LMHC
• Kyle Kowalewski, PA-C
• Lisa R Kozma, LMT
• KPH Healthcare Services, Inc. (Kinney Drugs #79)
• KPH Healthcare Services, Inc. (Kinney Drugs #51)
• Lauren Michelle Kraus, M.S. CCC-SLP, TSSLD

• Clinical Social Worker in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.