Kelli Lynn Sieczkowski, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW10655 Issued in AZ

Practice address

408 N Kendrick St
Suite 3
Flagstaff, AZ 86001-1582

Phone

(928) 774-6364

Fax

(928) 556-0504

NPI assigned

Feb 27, 2008

Last updated

Feb 27, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kelli Sieczkowski PLLCGroup PAC ID 2264700954, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kelli Sieczkowski, PLLC

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1851830582
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1740459460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E. KENDRICK ST.",
            "address_2": "SUITE 3",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-774-6364",
            "fax_number": "928-556-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N KENDRICK ST",
            "address_2": "SUITE 3",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011582",
            "telephone_number": "928-774-6364",
            "fax_number": "928-556-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIECZKOWSKI",
        "first_name": "KELLI",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW10655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Shows, MS, LPC
• Dan Shtutman, DO
• Kamilya Rae Shupe
• Sarah Shute, ATC, LAT
• Jivomir Siarov
• Marjolein Sieczkowski, LCSW
• Catherine Anne Sikora, MD
• Silverswing ABA Az LLC
• Shirl Simkins I, R.D.H.
• Haley Simmonds, CPM, LM

• Clinical Social Worker in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.