Kellee Purdy, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L4182 Issued in OR

Practice address

205 Behrends Ave
Juneau, AK 99801-1415

Phone

(971) 227-9277

NPI assigned

Jul 3, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kellee Purdy, LLC

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1174941066
  NPD (past) Authorized official
• Burstein-Rose PC

  • Clinical Social Worker
  • Portland, OR
  • NPI 1972917458
  NPD (past)

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1780847285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BEHRENDS AVE",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998011415",
            "telephone_number": "971-227-9277",
            "fax_number": "888-976-5806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BEHRENDS AVE",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998011415",
            "telephone_number": "971-227-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURDY",
        "first_name": "KELLEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "194005",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMAP (OREGON HEALTH PLAN)",
            "identifier": "500669839",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prism Eye Associates LLC
• Prism Midwifery LLC
• Mitzi Larae Privett, MSW
• Progressions Alaska LLC
• Ben Prom
• Mei Qiu, LMSW
• Nicole Quinto
• Niima Radford
• Richard Radford
• Yvonne Radu, RN

• Clinical Social Worker in Juneau, AK
• Providers in Juneau, AK by specialty
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.