Kelley Jean Grover, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC11550 Issued in ME

Practice address

540 Old County Rd
Etna, ME 04434-3818

Phone

(207) 577-1646

NPI assigned

Dec 6, 2006

Last updated

Jan 9, 2020By 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

Other names 1

• Kelley Jean Landry Former name

Medicare fee-for-service enrollment

Enrolled in ME

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

Medicare enrollment (NPD)

Enrolled

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.

• Kennebec Valley Mental Health Center

  dba Kennebec Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterville, ME
  • NPI 1679504864
  Medicare reassignment NPD
• Tri-County Mental Health Services

  • Mental Health Counselor
  • Lewiston, ME
  • NPI 1215979158
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1669531828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 S LIVERMORE RD",
            "city": "TURNER",
            "state": "ME",
            "postal_code": "042823102",
            "telephone_number": "207-577-1646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 OLD COUNTY RD",
            "city": "ETNA",
            "state": "ME",
            "postal_code": "044343818",
            "telephone_number": "207-577-1646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVER",
        "first_name": "KELLEY",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC11550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "LANDRY",
            "middle_name": "JEAN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tatsiana Fields, OT
• John Freeman Merrill, L.D
• New England Adaptive Equipment

• Clinical Social Worker in Etna, ME
• Providers in Etna, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.