Kellie Jurgonski, LISW-CP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

7159 Windmill Creek Rd
Charleston, SC 29414-7586

Phone

(317) 777-3024

NPI assigned

Jul 9, 2013

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1851732671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7159 WINDMILL CREEK RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147586",
            "telephone_number": "317-777-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7159 WINDMILL CREEK RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147586",
            "telephone_number": "317-777-3024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2040 Ashley River Rd Apt 527",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294078016",
            "country_code": "US",
            "telephone_number": "317-777-3024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JURGONSKI",
        "first_name": "KELLIE",
        "credential": "LISW-CP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2022-12-02",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Junkins
• Olga Leonidivna Junkulis, RN, CRNA
• Javier Jurado Velez
• Erica Ryan Juras, OD
• Adam Jurdak
• Cortenia Just Bourgeois
• Justiceworks Behavioral Care
• Bryce Andrew Justus, MD
• Laura Juul, M.D.
• JVB Physical Therapy Services, Inc.

• Clinical Social Worker in Charleston, SC
• Providers in Charleston, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.