Katherine Teresa Kellam, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904005806 Issued in VA

Practice address

11835 Hazel Circle Dr
Bristow, VA 20136-2180

Phone

(703) 396-7076

Fax

(703) 361-4335

NPI assigned

Mar 18, 2008

Last updated

Feb 28, 2013By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• United Methodist Family Services

  dba Leland House

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Richmond, VA
  • NPI 1598974669
  NPD (past)

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1811168826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13525 LELAND RD",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201202037",
            "telephone_number": "703-222-3558",
            "fax_number": "703-803-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 HAZEL CIRCLE DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201362180",
            "telephone_number": "703-396-7076",
            "fax_number": "703-361-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAM",
        "first_name": "KATHERINE",
        "middle_name": "TERESA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph&Mary Medical Transport Company
• Hye Jung Kang, PHARMACIST
• Jina Kang, BCBA, MED, LBA
• Kamalpreet Kaur, RPH
• Kayjoy Healthcare Services
• James Joseph Kelly IV
• Parveen Kelly, CPM, LM
• Brenda Lee Knighton, IBCLC
• Kathryn Leah Knodt, PTA
• Kristen Patricia Kolumbic, LCSW

• Clinical Social Worker in Bristow, VA
• Providers in Bristow, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; 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.