Individual provider Active NPI

Morgan Kiellach, LCSW

  • Clinical Social Worker
  • Fulton, NY
National Provider Identifier
1730646829
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
095948-01 Issued in NY
Practice address
98 N 2ND St Ste 100
Fulton, NY 13069-1254
Phone
(585) 447-2234
NPI assigned
Feb 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 095948-01 NY Primary

Addresses

Primary practice location

98 N 2ND St Ste 100
Fulton, NY 13069-1254

Mailing address

16 Commane Rd
Baldwinsville, NY 13027-9136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231109002770 NY Practitioner - Clinical Social Worker 5799132924 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
095948-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oswego Hospital CurrentSince Aug 28, 2023 Accepting new patients

Locations

98 N 2nd St
Ste 100
Fulton, NY 13069
Phone (315) 326-3555

98 N 2nd St
Fulton, NY 13069
Phone (315) 326-3555

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1730646829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 COMMANE RD",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130279136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 N 2ND ST STE 100",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130691254",
            "telephone_number": "585-447-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELLACH",
        "first_name": "MORGAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095948-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, NY

Sources for this page

Verify at the official NPI Registry.