Kevin M Kelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078200-1 Issued in NY

Practice address

951 Niagara Street
Drug & Alcohol Abuse Service Program
Buffalo, NY 14213

Phone

(716) 883-5344

Fax

(716) 884-1758

NPI assigned

Jan 11, 2007

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1740330992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 NIAGARA STREET",
            "address_2": "DRUG & ALCOHOL ABUSE SERVICE PROGRAM",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14213",
            "telephone_number": "716-883-5344",
            "fax_number": "716-884-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 NIAGARA STREET",
            "address_2": "DRUG & ALCOHOL ABUSE SERVICE PROGRAM",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14213",
            "telephone_number": "716-883-5344",
            "fax_number": "716-884-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "065920-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078200-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Kelly, DPT
• Gloria R. Kelly, SLP,TSHH,MA-CCC-SLP
• Gregory Daren Kelly
• Kara Maureen Kelly, MD
• Kathleen Kelly
• Kristen Marie Kelly, MD
• Margaret Ellen Crotty Kelly, RN, PNP
• Nina Cecelia Kelly, LPN
• Opal Kelly, MS
• Raymond Kelly, MD

• Clinical Social Worker in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.