Audrey Kiely

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089.0134524 Issued in VT

Practice address

109 Professional Dr Ste 3
Morrisville, VT 05661-9302

Phone

(802) 760-0919

NPI assigned

Jul 10, 2019

Last updated

Jun 2, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 6, 2024 through Jun 6, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Blue Spruce Therapy, LLC

  • Clinical Social Worker
  • Morrisville, VT
  • NPI 1083353353
  NPD Authorized official

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1700438736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 PROFESSIONAL DR STE 3",
            "city": "MORRISVILLE",
            "state": "VT",
            "postal_code": "056619302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PROFESSIONAL DR STE 3",
            "city": "MORRISVILLE",
            "state": "VT",
            "postal_code": "056619302",
            "telephone_number": "802-760-0919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Queen St Ste 13",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016102478",
            "country_code": "US",
            "telephone_number": "508-860-7930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIELY",
        "first_name": "AUDREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000224871",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0134524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Marie Jones, L.C.M.H.C.
• John Kaeding, MD
• Kate Donnally Licsw, LLC
• Marjorie Kelso, CNM
• Dana Elizabeth Kennedy, MD
• Philip G Kiely, M.D.
• Phil Kirk, PRSS
• Travis Ryan Knapp Sr., CRNA
• Mary Lou Kopas, ARNP, CNM
• KPH Healthcare Services, Inc. (Kinney Drugs #23)

• Clinical Social Worker in Morrisville, VT
• Providers in Morrisville, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.