Kellie Anne Nunn, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L12565 Issued in OR

Practice address

5 Centerpointe Dr Ste 320
Lake Oswego, OR 97035-8696

Phone

(971) 380-3853

NPI assigned

Apr 15, 2021

Last updated

Aug 28, 2024By 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 OR

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, 2018

Medicare assignment

May accept Medicare assignment

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.

• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178

  OR

  Medicare reassignment NPD
• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731
  NPD

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1780265454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 PARKVIEW DR APT P",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354473",
            "telephone_number": "952-261-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CENTERPOINTE DR STE 320",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358696",
            "telephone_number": "971-380-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNN",
        "first_name": "KELLIE",
        "middle_name": "ANNE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L12565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest Endocrinology, LLC
• Northwest Medical Clinic PC
• Northwest Mobility LLC
• Northwest Surgical Specialists PC (Rebound Lake Oswego)
• Hadi Nouredine, D.M.D.
• Nutrition for Autoimmunity, LLC
• Bradley A Nymeyer, LAC, LMT
• Samantha O'Brien, L.AC., LMT
• Kailey O'Connor
• Stephanie Kirsten O'Donnell-Peters

• Clinical Social Worker in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.