Individual provider Active NPI

Katherine Kezelian, LMSW

  • Clinical Social Worker
  • Royal Oak, MI
National Provider Identifier
1821383563
Registry record updated May 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801093226 Issued in MI
Practice address
307 W 6TH St Ste 201
Royal Oak, MI 48067-2548
Phone
(248) 463-8263
NPI assigned
Jun 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2025

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 6801093226 MI Primary

Addresses

Primary practice location

307 W 6TH St Ste 201
Royal Oak, MI 48067-2548

Mailing address

307 W 6TH St Ste 201
Royal Oak, MI 48067-2548
Phone (248) 463-8263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20141015002507 MI Practitioner - Clinical Social Worker 5294956280 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Katherine Kezelian, LLC Clinical CurrentSince Jun 1, 2025 Accepting new patients

Locations

307 W 6th St
Ste 201
Royal Oak, MI 48067
Phone (248) 463-8263

504 E 4th St
Royal Oak, MI 48067
Phone (248) 629-0285

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746835200000",
    "number": "1821383563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 W 6TH ST STE 201",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672548",
            "telephone_number": "248-463-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 W 6TH ST STE 201",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672548",
            "telephone_number": "248-463-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEZELIAN",
        "first_name": "KATHERINE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2025-05-10",
        "certification_date": "2025-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.