Kelly Lynn Van Dolson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2134 Issued in NH

Practice address

10 Members Way Ste 201
Dover, NH 03820-5933

Phone

(603) 742-2263

NPI assigned

Sep 19, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Van Dolson Counseling Services, PLLC

  • Adult Mental Health Clinic/Center
  • Epping, NH
  • NPI 1417774845
  NPD Authorized official

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1932481678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-742-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEMBERS WAY STE 201",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038205933",
            "telephone_number": "603-742-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DOLSON",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-19",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "119709",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "2134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3117655",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Laurie Vachon I
• Vada Wellness LLC
• Molly Ann Vaillincourt, LICSW, MLADC
• Ryan M Valente, M.D.
• Valor Ridge
• Katelyn Van Doorn, PSYD
• Frances Van Geyte, RD
• Michelle Van Gombos, RD, LDN
• Pilar Corah Van Patten, LMFT
• Paul Herman Van Slooten, MSW

• Clinical Social Worker in Dover, NH
• Providers in Dover, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.