Kelli Sieczkowski, PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LCSW10655 Issued in AZ

Legal business name

KELLI SIECZKOWSKI, PLLC

Practice address

1930 S Alma School Rd Ste D202
Mesa, AZ 85210-3045

Phone

(480) 630-0316

NPI assigned

Feb 14, 2017

Last updated

Jul 8, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Kelli Lynn Sieczkowski, LCSWNPI 1740459460

Title

Owner

Phone

(480) 630-0613

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelli Lynn Sieczkowski, LCSW

  • Clinical Social Worker
  • Flagstaff, AZ
  • NPI 1740459460
  Medicare reassignment Care Compare group NPD Authorized official
• Marjolein Sieczkowski, LCSW

  • Clinical Social Worker
  • Flagstaff, AZ
  • NPI 1457850984
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562544000000",
    "number": "1851830582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2469 W ZEPHER AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012543",
            "telephone_number": "928-225-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 S ALMA SCHOOL RD STE D202",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103045",
            "telephone_number": "480-630-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLI SIECZKOWSKI, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-14",
        "last_updated": "2019-07-08",
        "status": "A",
        "authorized_official_last_name": "SIECZKOWSKI",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-630-0613",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "LCSW10655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis George Keith II, D.V.M.
• Kazhra Angelique Mayan Kelcho
• Renee L Kelderhouse, M.S., CCC-SLP
• Duke Keller, D.O
• Molly Johanna Keller, BS, BHPP
• Jennifer Kelliher, LPN
• Julianna Kellner
• Ashley Thompson Kellogg, FNP
• Olivia Kellogg
• Hannah Kelly, MA

• Community/Behavioral Health Agency in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.