Active NPI
Deborah Ann Kelly, LICSW
- Clinical Social Worker
- Leominster, MA
National Provider Identifier
1942389382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1016244
- Practice address
- 1205 Central St
Leominster, MA 01453-5903 - Phone
- (978) 537-1835
- NPI assigned
- Nov 5, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1016244 | MA | Primary |
Addresses
Primary practice location
1205 Central St
Leominster, MA 01453-5903
Mailing address
1205 Central St
Leominster, MA 01453-5903
Phone (978) 537-1835
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005527 | Other | MA | VALUE OPTIONS |
| 717551 | Other | MA | TUFTS HEALTH PLAN ID |
| SO28275 | Other | MA | CHAMPUS |
| 55449731 | Other | MA | UNITED BEHAVIORAL HEALTH |
| 171035 | Other | MA | MAGELLAN |
| 7104711 | Other | MA | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1016244 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942389382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 CENTRAL ST",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014535903",
"telephone_number": "978-537-1835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 CENTRAL ST",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014535903",
"telephone_number": "978-537-1835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "DEBORAH",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1016244",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "005527",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN ID",
"identifier": "717551",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "SO28275",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "55449731",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "171035",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "7104711",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leominster, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.