Alisa Colleen Kelly-Martina, MSSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7189-123 Issued in WI

Practice address

629 River St
Belleville, WI 53508-9189

Phone

(608) 424-9100

Fax

(608) 424-9099

NPI assigned

Mar 16, 2007

Last updated

Jun 10, 2025By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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, 2000

Medicare assignment

May accept Medicare assignment

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Foundations Counseling Center, Inc.

  • Clinical Social Worker
  • Belleville, WI
  • NPI 1659579928
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1831223031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 EDWARD ST",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931005",
            "telephone_number": "608-424-0710",
            "fax_number": "608-424-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 RIVER ST",
            "city": "BELLEVILLE",
            "state": "WI",
            "postal_code": "535089189",
            "telephone_number": "608-424-9100",
            "fax_number": "608-424-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY-MARTINA",
        "first_name": "ALISA",
        "middle_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "credential": "MSSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7189-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40932200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristie Anne Harbour, MS
• David Layne Hardin, MD
• Shanaya Marie Hebgen, MD
• Danna Jenkins, MD
• Colin David Kavanaugh, MD
• Brian Kenealy, MD
• Makaya Kimberly King, MD
• Tina Marie Kolasa, RPH
• Ellyn Kyser, LPC
• Jillian Landeck, M.D.

• Clinical Social Worker in Belleville, WI
• Providers in Belleville, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.