Jennifer Ann Kelley, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801104321 Issued in MI

Practice address

939 Waterloo Ave
Monroe, MI 48161-1660

Phone

(734) 230-2915

NPI assigned

May 30, 2019

Sex

Female

Sole proprietor

Yes

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)

Not 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.

• This Iz Me

  • Adult Mental Health Clinic/Center
  • Monroe, MI
  • NPI 1508525858
  NPD Authorized official
• Mindful Operations LLC

  • Clinical Psychologist
  • Monroe, MI
  • NPI 1437824315
  NPD (past)

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1659939205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 WATERLOO AVE",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481611660",
            "telephone_number": "734-652-4573",
            "fax_number": "734-621-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 WATERLOO AVE",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481611660",
            "telephone_number": "734-230-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801104321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melani Kekulawala, MD
• Connie Sue Keller
• Elizabeth Marie Keller, S.T
• Natalie Keller
• Tammie L Kelley Stahr, RN
• Timothy James Kellie, CNP
• Lisa Marie Kelly, APRN
• Oscar Kelly
• Ketamine Institute of Michigan
• Phyllis Ann Kettlewell, CRNA

• Social Worker in Monroe, MI
• Providers in Monroe, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.