Kelly Jo Vancelette, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C003475 Issued in NC

Practice address

2076 Veterans Pkwy Ste 220
Clayton, NC 27520-5303

Phone

(855) 501-1004

NPI assigned

May 4, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Clinical Social Worker

Education

State University of New York at Buffalo School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

WakemedGroup PAC ID 7315937612, 72 clinicians

Mindpath Care Centers North Carolina PLLCGroup PAC ID 4688655517, 115 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpsc.kellyjovancelette@114018.advancedmd-direct.com

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.

• Mindpath Care Centers, North Carolina, PLLC

  • Psychiatry Physician
  • Durham, NC
  • NPI 1508803214

  Clinical

  Medicare reassignment Care Compare group NPD
• Wakemed

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1194907717

  Clinical

  Medicare reassignment Care Compare group NPD
• Wakemed

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302
  NPD

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1689622706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954",
            "telephone_number": "855-501-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2076 VETERANS PKWY STE 220",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205303",
            "telephone_number": "855-501-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCELETTE",
        "first_name": "KELLY JO",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C003475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003178",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Urgent Cares of America North Carolina Inc
• Sarah Jonell Utley, LCSWA
• Bhavna Vaidya-Tank, MD
• Claire Vallery, CO
• Erin Grace Van Vactor, NCC, LCMHC, M.S.
• Laura M Varela
• Rachael Purvis Veazey, DDS
• Gavin Cade Velazquez
• Rafael Viera Jr., PTA
• Erica Gaddis Vinson, LCMHCA, LCASA

• Clinical Social Worker in Clayton, NC
• Providers in Clayton, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.