Individual provider Active NPI

Kelley Renee Reed, L.C.S.W.

  • Clinical Social Worker
  • Ava, MO
National Provider Identifier
1750301784
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004904 Issued in MO
Practice address
603 South Jefferson Street
Ava, MO 65608
Phone
(417) 683-3398
NPI assigned
Jul 20, 2006
Last updated
May 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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 004904 MO Primary

Addresses

Primary practice location

603 South Jefferson Street
Ava, MO 65608

Mailing address

RR 1 Box 54B
Mountain Grove, MO 65711-9519
Phone (417) 259-9644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20061005000246 MO Practitioner - Clinical Social Worker 2466458047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Missouri, Columbia School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

904 Zimmerman Ave
Cabool, MO 65689-7365
Phone (417) 962-5422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas County Public Health Services Group, Inc. CurrentSince Jun 9, 2025 Accepting new patients
Douglas County Public Health Services Group, Inc. CurrentSince Jun 9, 2025 Accepting new patients

Locations

904 Zimmerman Ave
Cabool, MO 65689
Phone (417) 683-4831

1604 N Main St
#C
Mountain Grove, MO 65711
Phone (417) 926-1713

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1750301784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 54B",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657119519",
            "telephone_number": "417-259-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 SOUTH JEFFERSON STREET",
            "city": "AVA",
            "state": "MO",
            "postal_code": "65608",
            "telephone_number": "417-683-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "KELLEY",
        "middle_name": "RENEE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "004904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ava, MO

Sources for this page

Verify at the official NPI Registry.