Active NPI
Brandi K. Kelley, LCSW
- Clinical Social Worker
- Potsdam, NY
National Provider Identifier
1669896171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 087767
- Practice address
- 44 Pierrepont Ave
Potsdam, NY 13676-2200 - Phone
- (315) 261-8522
- NPI assigned
- Feb 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 087767 | NY | Primary |
Addresses
Primary practice location
44 Pierrepont Ave
Potsdam, NY 13676-2200
Mailing address
44 Pierrepont Ave
Potsdam, NY 13676-2200
Phone (315) 261-8522
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 087767 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lawrence County | Past | Accepting new patients | |
| St Lawrence County | Social Worker | 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.
-
- Multi-Specialty Clinic/Center
- Canton, NY
- NPI 1861551822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578614400000",
"number": "1669896171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 PIERREPONT AVE",
"city": "POTSDAM",
"state": "NY",
"postal_code": "136762200",
"telephone_number": "315-261-8522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 PIERREPONT AVE",
"city": "POTSDAM",
"state": "NY",
"postal_code": "136762200",
"telephone_number": "315-261-8522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "BRANDI",
"middle_name": "K.",
"name_prefix": "Miss",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-05",
"last_updated": "2020-01-10",
"certification_date": "2020-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "087767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Potsdam, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.