Individual provider Active NPI

Kelly Ann Clana, LCSW

  • Clinical Social Worker
  • Marianna, FL
National Provider Identifier
1790827285
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 5716 Issued in FL
Practice address
2944 Penn Ave Ste L
Marianna, FL 32448-2741
Phone
(850) 526-5500
Fax
(850) 526-5536
NPI assigned
Feb 13, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 SW 5716 FL Primary

Addresses

Primary practice location

2944 Penn Ave Ste L
Marianna, FL 32448-2741

Mailing address

2310 W Indianhead Dr
Tallahassee, FL 32301-5868
Phone (850) 591-1959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120427000201 FL Practitioner - Clinical Social Worker 1355503988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chrysalis Center, Inc.Group PAC ID 8325186646, 36 clinicians

Practice addresses (Care Compare)

3800 W Broward Blvd
Suite 100
Fort Lauderdale, FL 33312-1018
Phone (954) 587-1008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 5716FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chrysalis Center, LLC CurrentSince Nov 1, 2023 Accepting new patients
Florida Therapy Services, Inc PastSince Jul 17, 2021 Accepting new patients

Locations

3800 W Broward Blvd
Ste 100
Ft Lauderdale, FL 33312

2944 Penn Ave
Ste L
Marianna, FL 32448
Phone (850) 526-5500

421 W Oak Ave
Panama City, FL 32401
Phone (850) 215-6007

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790827285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 W INDIANHEAD DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323015868",
            "telephone_number": "850-591-1959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2944 PENN AVE STE L",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324482741",
            "telephone_number": "850-526-5500",
            "fax_number": "850-526-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANA",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 5716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marianna, FL

Sources for this page

Verify at the official NPI Registry.