Kellen Glynn Derhay, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW24284 Issued in FL

Practice address

7305 N Military TRL
Riviera Beach, FL 33410-7417

Phone

(561) 422-8262

NPI assigned

Feb 25, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1710784186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7305 N MILITARY TRL",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334107417",
            "telephone_number": "561-422-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 N MILITARY TRL",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334107417",
            "telephone_number": "561-422-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERHAY",
        "first_name": "KELLEN",
        "middle_name": "GLYNN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW24284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Department of Veterans Affairs
• Department of Veterans Affairs Medical Center West Palm Beach
• Department of Veterans Affiars
• Dependable Medical Equipment LLC
• Dept of Veterans Affairs Medical Center
• Andre Desgroseillers, MD
• Saradienne Desir
• Heather Leigh Destefano, LCSW
• John A Destefano, D.P.M.
• Monroe Desulma

• Clinical Social Worker in Riviera Beach, FL
• Providers in Riviera Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.