Individual provider Active NPI

Lynn M. Kegley, LICSW

  • Clinical Social Worker
  • Nashua, NH
National Provider Identifier
1841300969
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
649 Issued in NH
Practice address
154 Broad St Ste 1511
Nashua, NH 03063-3205
Phone
(603) 577-5551
Fax
(603) 577-5576
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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 649 NH Primary

Addresses

Primary practice location

154 Broad St Ste 1511
Nashua, NH 03063-3205

Mailing address

154 Broad St Ste 1511
Nashua, NH 03063-3205
Phone (603) 577-5551

Other identifiers 1

IdentifierTypeStateIssuer
30423693MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
649NHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1841300969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 BROAD ST STE 1511",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030633205",
            "telephone_number": "603-577-5551",
            "fax_number": "603-577-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 BROAD ST STE 1511",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030633205",
            "telephone_number": "603-577-5551",
            "fax_number": "603-577-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEGLEY",
        "first_name": "LYNN",
        "middle_name": "M.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30423693",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.