Active NPI
Kelly Raymond, LMSW
- Clinical Social Worker
- Benton Harbor, MI
National Provider Identifier
1861746869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801094448
- Practice address
- 1485 M 139
Benton Harbor, MI 49022-5711 - Phone
- (269) 934-3444
- Fax
- (269) 927-8660
- NPI assigned
- Oct 30, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801094448 | MI | Primary |
Addresses
Primary practice location
1485 M 139
Benton Harbor, MI 49022-5711
Mailing address
1485 M 139
Benton Harbor, MI 49022-5711
Phone (269) 934-3444
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6801094448 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482883200000",
"number": "1861746869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1485 M 139",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490225711",
"telephone_number": "269-934-3444",
"fax_number": "269-927-8660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1485 M 139",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490225711",
"telephone_number": "269-934-3444",
"fax_number": "269-927-8660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYMOND",
"first_name": "KELLY",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-30",
"last_updated": "2016-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801094448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.