Margaret Mary Kelly, MSW, MDIV, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20067 Issued in MN

Practice address

3038 41St Ave S
Minneapolis, MN 55406-2231

Phone

(612) 770-6209

NPI assigned

Oct 24, 2022

Sex

Female

Sole proprietor

Yes

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 MN

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hennepin CountyGroup PAC ID 7911892849, 132 clinicians

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 and National Provider Directory roles.

• Hennepin County

  • Psychiatry Physician
  • Minneapolis, MN
  • NPI 1780790345

  Clinical

  Medicare reassignment Care Compare group NPD
• Hennepin County

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1962147413
  NPD

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1811614589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3038 41ST AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3038 41ST AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062231",
            "telephone_number": "612-770-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MARGARET",
        "middle_name": "MARY",
        "credential": "MSW, MDIV, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ann Kelly, PT
• Kamran Kelly
• Kathleen Kelly
• Kevin M Kelly, MD
• Lance Kelly
• Mary Kelly, PA
• Maura Kelly, DPT
• Rosemary Frances Kelly, MD
• Ryan Kelly, M.D.
• Sara Anne Kelly, LICSW

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.