Individual provider Active NPI

Brea Symone Jarrett-Kelly, LCSW

  • Clinical Social Worker
  • Little Rock, AR
National Provider Identifier
1922536895
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10447-C Issued in AR
Practice address
400 Hardin Rd Ste 150
Little Rock, AR 72211-3507
Phone
(501) 603-2147
Fax
(501) 603-0324
NPI assigned
May 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 10447-M AR
Clinical Social Worker 1041C0700X 10447-C AR Primary

Addresses

Primary practice location

400 Hardin Rd Ste 150
Little Rock, AR 72211-3507

Mailing address

400 Hardin Rd Ste 150
Little Rock, AR 72211-3507
Phone (501) 603-2147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20250916000103 AR Practitioner - Clinical Social Worker 9335643261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

400 Edison
Benton, AR 72015-5359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10447-MARMDSocial Worker
10447-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Soul (ER) Therapy Clinical Current Accepting new patients
Gateway Family Therapy Services PLLC Clinical CurrentSince Sep 2, 2025 Accepting new patients

Locations

400 Edison
Benton, AR 72015
Phone (501) 425-6476

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1922536895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HARDIN RD STE 150",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113507",
            "telephone_number": "501-603-2147",
            "fax_number": "501-603-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HARDIN RD STE 150",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113507",
            "telephone_number": "501-603-2147",
            "fax_number": "501-603-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRETT-KELLY",
        "first_name": "BREA",
        "middle_name": "SYMONE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-23",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "10447-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "10447-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.