Individual provider Active NPI

Kelly Joyce, MSW, LSW

  • Clinical Social Worker
  • Austintown, OH
National Provider Identifier
1912522087
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
5760 Patriot Blvd
Austintown, OH 44515-1170
Phone
(330) 953-0243
NPI assigned
Jun 14, 2020
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I.2002437 OH
Social Worker 104100000X S.1700563 OH
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

5760 Patriot Blvd
Austintown, OH 44515-1170

Mailing address

39 N Hillside Rd
Canfield, OH 44406-1336
Phone (330) 550-7491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20201123002475 OH Practitioner - Clinical Social Worker 0840601811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
On Demand Counseling LLCGroup PAC ID 0941554133, 17 clinicians

Practice addresses (Care Compare)

5760 Patriot Blvd
Suite C
Austintown, OH 44515-1170
Phone (330) 270-8610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1700563OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
On Demand Counseling LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1592092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1912522087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 N HILLSIDE RD",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444061336",
            "telephone_number": "330-550-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5760 PATRIOT BLVD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445151170",
            "telephone_number": "330-953-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOYCE",
        "first_name": "KELLY",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-14",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.2002437",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1700563",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austintown, OH

Sources for this page

Verify at the official NPI Registry.