Carol J. Kelly, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I9919 Issued in OH

Practice address

68 W Church St Ste 318
Newark, OH 43055-5050

Phone

(740) 281-1777

Fax

(740) 281-1778

NPI assigned

Sep 26, 2014

Last updated

Mar 15, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mid-Ohio Psychological Services Inc

  • Counselor
  • Lancaster, OH
  • NPI 1013274273
  NPD

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1932501566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 W CHURCH ST STE 318",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430555050",
            "telephone_number": "740-281-1777",
            "fax_number": "740-281-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 W CHURCH ST STE 318",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430555050",
            "telephone_number": "740-281-1777",
            "fax_number": "740-281-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CAROL",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I9919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Keck
• Keith a Wing DDS & Matthew P Mack Christopher R Smith DDS Inc (Wing, Mack & Smith DDS, Inc)
• Amanda May Keith, L.M.T.
• Loren Lea Keith
• Jerri Kelley
• Brittney Kay Kelso
• Laraine Brook Kemery, APRN-CNP
• Christopher Leroy Kennedy
• Daniel William Kennedy, M.D.
• Meredith Kennedy, SWA

• Clinical Social Worker in Newark, OH
• Providers in Newark, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.