Active NPI
Kellyn Jones, LCSW
- Clinical Social Worker
- Greenville, KY
National Provider Identifier
1659547503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3571
- Practice address
- 506 W. Hopkinsville St
Greenville, KY 42345 - Phone
- (270) 886-2205
- Fax
- (270) 886-0392
- NPI assigned
- May 1, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | 3571 | KY | Primary |
Addresses
Primary practice location
506 W. Hopkinsville St
Greenville, KY 42345
Mailing address
506 W. Hopkinsville St
Greenville, KY 42345
Phone (270) 886-2205
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30602015 | Medicaid | KY |
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 |
|---|---|---|---|
| 5041 | KY | MD | Clinical Social Worker |
| 3571 | KY | MD | Pediatric Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeskills, Inc. | Past | Accepting new patients | |
| Lifeskills, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Developmentally Disabled Services Day Training Agency
- Hopkinsville, KY
- NPI 1346321643
-
- Community/Behavioral Health Agency
- Bowling Green, KY
- NPI 1669401816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349136000000",
"number": "1659547503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 W. HOPKINSVILLE ST",
"city": "GREENVILLE",
"state": "KY",
"postal_code": "42345",
"telephone_number": "270-886-2205",
"fax_number": "270-886-2205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 W. HOPKINSVILLE ST",
"city": "GREENVILLE",
"state": "KY",
"postal_code": "42345",
"telephone_number": "270-886-2205",
"fax_number": "270-886-0392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "KELLYN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-01",
"last_updated": "2012-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "3571",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30602015",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.