John Patrick Kelty, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-11215 Issued in AZ

Practice address

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Phone

(602) 344-5651

Fax

(602) 344-5578

NPI assigned

Aug 29, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639288301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5177",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850105177",
            "telephone_number": "602-344-5651",
            "fax_number": "602-344-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5651",
            "fax_number": "602-344-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELTY",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-11215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Marie Kelsen, PMHNP-BC
• James Kelsey, LPTA
• Rachel Kelsey, MD
• Christina M Kelso, AU.D.
• Kelton Ericson DMD MD PLLC
• Kelvin S Crezee DPM PC
• David Edward Kem, D.D.S.
• Laura Kemery, M.S. CCC-SLP
• Aaron W Kemp, MD
• Andrea Kemp, PMHNP

• Clinical Social Worker in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Social Worker in Arizona

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.