Active NPI
Mary Lee Kelly, LCSW
- Clinical Social Worker
- Montoursville, PA
National Provider Identifier
1629030580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW008313L
- Practice address
- 252 Broad St
Montoursville, PA 17754 - Phone
- (570) 368-4744
- Fax
- (570) 368-4741
- NPI assigned
- Apr 5, 2006
- Sex
- Female
- 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 | SW008313L | PA | Primary |
Addresses
Primary practice location
252 Broad St
Montoursville, PA 17754
Mailing address
252 Broad St
Montoursville, PA 17754
Phone (570) 368-4744
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW008313L | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1629030580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "252 BROAD ST",
"city": "MONTOURSVILLE",
"state": "PA",
"postal_code": "17754",
"telephone_number": "570-368-4744",
"fax_number": "570-368-4741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "252 BROAD ST",
"city": "MONTOURSVILLE",
"state": "PA",
"postal_code": "17754",
"telephone_number": "570-368-4744",
"fax_number": "570-368-4741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MARY",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "SW008313L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montoursville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.