Individual provider Active NPI

Kellie Anne Jondro, MSW, LCSW

  • Clinical Social Worker
  • Cranston, RI
National Provider Identifier
1760287809
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW04460 Issued in RI
Practice address
1150 Reservoir Ave Ste 203
Cranston, RI 02920-6032
Phone
(401) 259-0340
Fax
(401) 213-8538
NPI assigned
Feb 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW6355 FL
Clinical Social Worker 1041C0700X ISW04460 RI Primary

Addresses

Primary practice location

1150 Reservoir Ave Ste 203
Cranston, RI 02920-6032

Mailing address

1150 Reservoir Ave Ste 203
Cranston, RI 02920-6032
Phone (401) 259-0340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20250826000530 RI Practitioner - Clinical Social Worker 6901306760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island Counseling Associates LLCGroup PAC ID 7618219544, 42 clinicians

Practice addresses (Care Compare)

1150 Reservoir Ave
Suite 203
Cranston, RI 02920-6043
Phone (401) 259-0340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW6355FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Counseling Associates LLC CurrentSince Jul 8, 2025 Accepting new patients

Locations

1150 Reservoir Ave
Ste 203
Cranston, RI 02920
Phone (401) 259-0340

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": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1760287809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 RESERVOIR AVE STE 203",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206032",
            "telephone_number": "401-259-0340",
            "fax_number": "401-213-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 RESERVOIR AVE STE 203",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206032",
            "telephone_number": "401-259-0340",
            "fax_number": "401-213-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONDRO",
        "first_name": "KELLIE",
        "middle_name": "ANNE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6355",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW04460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.