Active NPI
Steven Kelly, LCSW
- Clinical Social Worker
- Provo, UT
National Provider Identifier
1932330693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7364059-3501
- Practice address
- 151 S University Ave # 1400
Provo, UT 84601-4427 - Phone
- (801) 851-7118
- NPI assigned
- Jul 29, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 7364059-3502 | UT | |
| Clinical Social Worker | 1041C0700X | 7364059-3501 | UT | Primary |
Addresses
Primary practice location
151 S University Ave # 1400
Provo, UT 84601-4427
Mailing address
2374 West 960 North
Provo, UT 84601-1718
Phone (435) 671-7759
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7364059-3502 | Other | UT | CERTIFIED SOCIAL WORKER LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | SKELLY455457@DIRECT.MED.UTAH.EDU | Direct | University of Utah |
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 |
|---|---|---|---|
| 7364059-3502 | UT | MD | Social Worker |
| 7364059-3501 | UT | MD | Clinical Social Worker |
Interoperability endpoints
- skelly455457@direct.med.utah.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654646400000",
"number": "1932330693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2374 WEST 960 NORTH",
"city": "PROVO",
"state": "UT",
"postal_code": "846011718",
"telephone_number": "435-671-7759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 S UNIVERSITY AVE # 1400",
"city": "PROVO",
"state": "UT",
"postal_code": "846014427",
"telephone_number": "801-851-7118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "STEVEN",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-29",
"last_updated": "2022-06-08",
"certification_date": "2022-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "7364059-3502",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "7364059-3501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED SOCIAL WORKER LICENSE",
"identifier": "7364059-3502",
"state": "UT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "SKELLY455457@DIRECT.MED.UTAH.EDU",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.