Active NPI
Kelly Kurtz, LCSW, LICSW
- Clinical Social Worker
- Washington, DC
National Provider Identifier
1922758192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904012926
- Practice address
- 1627 K St NW Ste 500
Washington, DC 20006-1708 - Phone
- (202) 515-1993
- NPI assigned
- Mar 28, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC200001860 | DC | |
| Clinical Social Worker | 1041C0700X | 0904012926 | VA | Primary |
Addresses
Primary practice location
1627 K St NW Ste 500
Washington, DC 20006-1708
Mailing address
1627 K St NW Ste 500
Washington, DC 20006-1708
Other practice location 1
928 Belvedere Blvd
Charlottesville, VA 22901-3202
Phone (301) 335-5548
Other names 1
- Kelly Wason
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Simplepractice.com |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC200001860 | DC | MD | Clinical Social Worker |
| 0904012926 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649376000000",
"number": "1922758192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1627 K ST NW STE 500",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200061708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1627 K ST NW STE 500",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200061708",
"telephone_number": "202-515-1993"
}
],
"practiceLocations": [
{
"address_1": "928 Belvedere Blvd",
"address_purpose": "LOCATION",
"city": "Charlottesville",
"state": "VA",
"postal_code": "229013202",
"country_code": "US",
"telephone_number": "301-335-5548",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KURTZ",
"first_name": "KELLY",
"name_prefix": "Mrs.",
"credential": "LCSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-28",
"last_updated": "2022-04-08",
"certification_date": "2022-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC200001860",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904012926",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Simplepractice.com",
"affiliation": "N",
"address_1": "1627 K St NW Ste 500",
"city": "Washington",
"state": "DC",
"country_code": "US",
"postal_code": "200061708",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KELLY",
"last_name": "WASON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.