William Nathaniel Kelly III, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

86426 Issued in CA

Practice address

10509 San Diego Mission Rd Ste P
San Diego, CA 92108-2202

Phone

(619) 500-7088

Fax

(619) 314-4252

NPI assigned

Dec 9, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Solpath Family Counseling & Wellness Corp

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1659194900
  NPD (past)

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677369600000",
    "number": "1881025302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 48TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921021326",
            "telephone_number": "803-467-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10509 SAN DIEGO MISSION RD STE P",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082202",
            "telephone_number": "619-500-7088",
            "fax_number": "619-314-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "WILLIAM",
        "middle_name": "NATHANIEL",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-09",
        "last_updated": "2023-02-26",
        "certification_date": "2023-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "86426",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011880",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15681",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Kelly
• Thomas F Kelly, M.D.
• Thomas Gerald Kelly, M.D.
• Tyler Kelly
• Valerie Jean Kelly, M. A. CCC-SLP
• Andrew Kelm
• Michael J Kelner, M.D.
• Sydnie Lauren Kelsch
• Adam Kelsey, MLS
• Jessica Kelsey, MD

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2023; 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.