Active NPI
Kelly H Gonzalez, LCSW
- Social Worker
- Fort Stewart, GA
National Provider Identifier
1902900699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LSW0000004347
- Practice address
- 1061 Harmon Ave
Fort Stewart, GA 31314-5641 - Phone
- (912) 435-5313
- NPI assigned
- Sep 12, 2006
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | LSW0000004347 | TN | Primary |
Addresses
Primary practice location
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Mailing address
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4117927 | Other | MAGELLAN NAVIGATOR | |
| 620582605 | Other | INTIAL GROUP GROUP | |
| 620582605 | Other | THREE RIVERS PROVI GROUP | |
| 334969 | Other | VALUE OPTIONS GROUP | |
| 4117927 | Other | MAGELLAN SUMMIT | |
| 4117927 | Other | MAGELLAN PINNACLE |
Other names 1
- Miss Kelly L Harper
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 |
|---|---|---|---|
| LSW0000004347 | TN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715385600000",
"number": "1902900699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 HARMON AVE",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1061 HARMON AVE",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145641",
"telephone_number": "912-435-5313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "KELLY",
"middle_name": "H",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-12",
"last_updated": "2024-05-11",
"certification_date": "2024-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TN",
"license": "LSW0000004347",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN NAVIGATOR",
"identifier": "4117927",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTIAL GROUP GROUP",
"identifier": "620582605",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THREE RIVERS PROVI GROUP",
"identifier": "620582605",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS GROUP",
"identifier": "334969",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN SUMMIT",
"identifier": "4117927",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN PINNACLE",
"identifier": "4117927",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "HARPER",
"middle_name": "L",
"prefix": "MISS",
"credential": "MSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fort Stewart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.