Kelly Elizabeth Richards, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW8079 Issued in FL

Practice address

21 W Fee Ave
Suite G
Melbourne, FL 32901-4402

Phone

(321) 951-3949

NPI assigned

Jun 20, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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 names 1

• Miss Kelly Elizabeth Swain Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Center for Life Enhancement LLC

  • Clinical Social Worker
  • Melbourne, FL
  • NPI 1629148960
  NPD (past)

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720283674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ROSSETTER CIR",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329034123",
            "telephone_number": "321-951-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W FEE AVE",
            "address_2": "SUITE G",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329014402",
            "telephone_number": "321-951-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "SWAIN",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard S Rogers DC Chartered
• Richard T Elmore Jr PHD PA
• Richard Wilson Leong Jr DDS PA
• Ceirra Richard
• Lauren-Danielle Richard, OTA
• Victoria Richards, BCABA
• Melanie April Richardson, ARNP
• Peyton Lynn Richardson, PT, DPT
• Ronald Edward Richardson Jr., DDS
• Tiffany Pamela Richason, M.D.

• Clinical Social Worker in Melbourne, FL
• Providers in Melbourne, 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 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.