Active NPI
Brian Kelly, LICSW
- Clinical Social Worker
- Newton, MA
National Provider Identifier
1598832479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1029609
- Practice address
- 7 Pennsylvania Ave
Newton, MA 02464-1357 - Phone
- (774) 306-6540
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- 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 | 1029609 | MA | Primary |
Addresses
Primary practice location
7 Pennsylvania Ave
Newton, MA 02464-1357
Mailing address
7 Pennsylvania Ave
Newton, MA 02464-1357
Phone (774) 306-6540
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 699909 | Other | MA | TUFTS |
| P07461 | Other | MA | BCBS |
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 |
|---|---|---|---|
| 1029609 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Castlebrook Counseling Services, Inc. | Clinical | Past | Accepting new patients |
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.
-
- Clinical Social Worker
- Westborough, MA
- NPI 1982045860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744070400000",
"number": "1598832479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 PENNSYLVANIA AVE",
"city": "NEWTON",
"state": "MA",
"postal_code": "024641357",
"telephone_number": "774-306-6540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 PENNSYLVANIA AVE",
"city": "NEWTON",
"state": "MA",
"postal_code": "024641357",
"telephone_number": "774-306-6540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "BRIAN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2025-04-08",
"certification_date": "2025-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1029609",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "699909",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "P07461",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.