Kelly Odea Landes, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904005663 Issued in VA

Practice address

922 9 And a Half St
Charlottesville, VA 22903

Phone

(434) 981-4686

Fax

(434) 977-6323

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

No

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

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710044292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 ELLINGTON BEND",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22903",
            "telephone_number": "434-981-4686",
            "fax_number": "434-977-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 9 AND A HALF ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22903",
            "telephone_number": "434-981-4686",
            "fax_number": "434-977-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDES",
        "first_name": "KELLY",
        "middle_name": "ODEA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11526617",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cy Andrew Lampugnale, PA
• Amy Lance, OD
• Charles N. Landen Jr., M.D.
• Christopher Lander, MD
• Daniel A. Landes
• Joshua Lee Landis, APRN, FNP-C
• Courtney Lee Lane, PMHNP-BC
• Margaret D Lane, PT
• Jane Rice Langan, PHARM.D
• Jennifer Ellen Langer, MD

• Clinical Social Worker in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.