Kelly Dulohery, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20650 Issued in MN

Practice address

1695 Lor Ray Dr
North Mankato, MN 56003-2804

Phone

(507) 385-6548

NPI assigned

Jul 24, 2015

Last updated

Jan 21, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdulohery90026@ehrdirect.mayoclinicmsg.org

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.

• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System - Mankato

  • Multi-Specialty Clinic/Center
  • Mankato, MN
  • NPI 1578545422
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System-Waseca

  • Multi-Specialty Clinic/Center
  • Waseca, MN
  • NPI 1518494251
  NPD

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1861877490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 LOR RAY DR",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560032804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 LOR RAY DR",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560032804",
            "telephone_number": "507-385-6548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULOHERY",
        "first_name": "KELLY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-24",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdulohery90026@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1695 Lor Ray Dr",
            "city": "North Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560032804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nicolaas James Theodore Dubbelde, D.C.
• Gary Richard Eichmeyer, D.D.S.
• Christopher Jerald Evans
• Femrite Family Nutrition, Inc.
• Keith P Flack, DDS
• McKailey May George

• Clinical Social Worker in North Mankato, MN
• Providers in North Mankato, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.