Individual provider Active NPI

Luretha Kelly, LCSW

  • Clinical Social Worker
  • Clinton, MS
National Provider Identifier
1609173533
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C6936 Issued in MS
Practice address
114 Stone CV
Clinton, MS 39056-5020
Phone
(601) 572-4268
Fax
(601) 885-6028
NPI assigned
Feb 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C6936 MS
Social Worker 104100000X M6936 MS
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C6936 MS Primary

Addresses

Primary practice location

114 Stone CV
Clinton, MS 39056-5020

Mailing address

114 Stone CV
Clinton, MS 39056-5020
Phone (601) 572-4268

Other identifiers 1

IdentifierTypeStateIssuer
08434862MedicaidMS

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

LicenseStateTypeSpecialty
C6936MSMDMental Health Counselor
M6936MSMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sowing Seeds, LLC Mental Health CurrentSince Aug 25, 2024 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.

NPI Registry JSON

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

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1609173533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 STONE CV",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565020",
            "telephone_number": "601-572-4268",
            "fax_number": "601-488-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 STONE CV",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565020",
            "telephone_number": "601-572-4268",
            "fax_number": "601-885-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LURETHA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-11",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "C6936",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MS",
            "license": "M6936",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C6936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08434862",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.