Active NPI
Colby Lynn Kelley, LSW
- Social Worker
- Saint Louis, MO
National Provider Identifier
1790462117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.112789
- Practice address
- 515 N Jefferson Ave
Saint Louis, MO 63103-3000 - Phone
- (314) 482-0765
- Fax
- (314) 289-6543
- NPI assigned
- Jun 28, 2023
- Last updated
- Apr 6, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.112789 | IL | Primary |
Addresses
Primary practice location
515 N Jefferson Ave
Saint Louis, MO 63103-3000
Mailing address
515 N Jefferson Ave
Saint Louis, MO 63103-3000
Phone (314) 482-0765
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.112789 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775433600000",
"number": "1790462117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 N JEFFERSON AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631033000",
"telephone_number": "314-482-0765",
"fax_number": "314-289-6543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 N JEFFERSON AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631033000",
"telephone_number": "314-482-0765",
"fax_number": "314-289-6543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "COLBY",
"middle_name": "LYNN",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-28",
"last_updated": "2026-04-06",
"certification_date": "2026-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.112789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.