Ginny Lynn Kelly, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1028860 Issued in MA

Practice address

104 Charles Eldridge Dr
Lakeville, MA 02347

Phone

(508) 947-1683

Fax

(508) 947-1684

NPI assigned

Aug 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MA

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

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tranquil Mind and Wellness, IncGroup PAC ID 9032191978, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tranquil Mind & Wellness, Inc

  • Mental Health Counselor
  • Lakeville, MA
  • NPI 1376754267
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619980992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CHARLES ELDRIDGE DR",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "02347",
            "telephone_number": "508-947-1683",
            "fax_number": "508-947-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CHARLES ELDRIDGE DR",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "02347",
            "telephone_number": "508-947-1683",
            "fax_number": "508-947-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "GINNY",
        "middle_name": "LYNN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1028860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frannie Hsu
• Illumination Psychotherapy Services, LLC.
• In Sight Healing and Counseling LLC
• Island Terrace, Inc. (Island Terrace Nursing Home)
• Rhiannon Jackson, LMHC
• Ghassan A Khoury, DMD,MPH,PC
• Cherie Kish, HIS
• Jennifer L Koester, MSN, APRN, FNP-C
• Judy Kohut
• Lakeside Mental Health, PLLC

• Clinical Social Worker in Lakeville, MA
• Providers in Lakeville, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.