Active NPI
Kelly J. Urena, LMSW
- Social Worker
- Wyandanch, NY
National Provider Identifier
1922860428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 099685-01
- Practice address
- 792 Mount Ave
Wyandanch, NY 11798-4430 - Phone
- (917) 365-0699
- NPI assigned
- Jan 29, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 099685-01 | NY | Primary |
Addresses
Primary practice location
792 Mount Ave
Wyandanch, NY 11798-4430
Mailing address
51 Meyer Ave
Valley Stream, NY 11580-3123
Phone (917) 365-0699
Other names 1
- Kelly J. Urena
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 |
|---|---|---|---|
| 099685-01 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706486400000",
"number": "1922860428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 MEYER AVE",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115803123",
"telephone_number": "917-365-0699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "792 MOUNT AVE",
"city": "WYANDANCH",
"state": "NY",
"postal_code": "117984430",
"telephone_number": "917-365-0699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "URENA",
"first_name": "KELLY",
"middle_name": "J.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-29",
"last_updated": "2024-01-29",
"certification_date": "2024-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "099685-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "URENA",
"middle_name": "J.",
"credential": "LMSW",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Wyandanch, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.