Christie Kelly, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8406-C Issued in AR

Practice address

4701 Fairway Ave
North Little Rock, AR 72116-8066

Phone

(501) 771-8261

Fax

(501) 771-8263

NPI assigned

May 5, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1669908984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 FAIRWAY AVE STE B",
            "city": "N LITTLE ROCK",
            "state": "AR",
            "postal_code": "721168069",
            "telephone_number": "501-771-8261",
            "fax_number": "501-771-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 FAIRWAY AVE",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721168066",
            "telephone_number": "501-771-8261",
            "fax_number": "501-771-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CHRISTIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "AR",
            "license": "8406-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "8406-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred William Keller III, MD
• Morris Eugene Kelley, M.D.
• Shirley Gail Kelley, R.N.
• Teri Kelley, MHPP
• Kelli Keene Sanders, MD Inc
• Kaitlyn Kelsay
• Kencur Inc Statco Hearing Labs
• Jacqueline Sarah Kennard
• Bobbie Jo Kennedy
• Mary Elizabeth Kennedy, PSYD, LPC

• Clinical Social Worker in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.

Verify at the official NPI Registry.