Individual provider Active NPI

Deverie Ann Kelley, LCSW, LAC

  • Clinical Social Worker
  • Helena, MT
National Provider Identifier
1932519089
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BBH-LCSW-LIC-30553 Issued in MT
Practice address
2001 11TH Ave Ste 6
Helena, MT 59601-4808
Phone
(406) 603-4151
Fax
(406) 442-0248
NPI assigned
Apr 29, 2014
Last updated
Feb 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X BBH-LAC-LIC-3377 MT
Clinical Social Worker 1041C0700X BBH-LCSW-LIC-30553 MT Primary

Addresses

Primary practice location

2001 11TH Ave Ste 6
Helena, MT 59601-4808

Mailing address

2001 11TH Ave Ste 6
Helena, MT 59601-4808
Phone (406) 603-4151

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

LicenseStateTypeSpecialty
BBH-LAC-LIC-3377MTMDAddiction (Substance Use Disorder) Counselor
BBH-LCSW-LIC-30553MTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1932519089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 11TH AVE STE 6",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014808",
            "telephone_number": "406-603-4151",
            "fax_number": "406-442-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 11TH AVE STE 6",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014808",
            "telephone_number": "406-603-4151",
            "fax_number": "406-442-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "DEVERIE",
        "middle_name": "ANN",
        "credential": "LCSW, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "BBH-LAC-LIC-3377",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-30553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Helena, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.