Active NPI
Kelli Mangold, LCSW
- Clinical Social Worker
- Amarillo, TX
National Provider Identifier
1669921029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-51139
- Practice address
- 2417 Hobbs Rd Ste 105
Amarillo, TX 79109-1533 - Phone
- (806) 471-0334
- Fax
- (806) 318-3046
- NPI assigned
- Sep 27, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-51139 | TX | Primary |
Addresses
Primary practice location
2417 Hobbs Rd Ste 105
Amarillo, TX 79109-1533
Mailing address
PO Box 271
Canyon, TX 79015-0271
Phone (806) 471-0334
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 |
|---|---|---|---|
| LCSW-51139 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mangold Enterprise | Clinical | Current | Accepting new patients |
Locations
2417 Hobbs Rd
Ste 105
Amarillo, TX 79109
Phone (806) 471-0334
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647388800000",
"number": "1669921029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 271",
"city": "CANYON",
"state": "TX",
"postal_code": "790150271",
"telephone_number": "806-471-0334",
"fax_number": "806-318-3046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2417 HOBBS RD STE 105",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791091533",
"telephone_number": "806-471-0334",
"fax_number": "806-318-3046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGOLD",
"first_name": "KELLI",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-27",
"last_updated": "2022-03-16",
"certification_date": "2022-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "LCSW-51139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.