Individual provider Active NPI

Kelli Lynch-O'Brien, LCSW

  • Clinical Social Worker
  • Blacksburg, VA
National Provider Identifier
1942974001
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904012889 Issued in VA
Practice address
700 University City Blvd
Blacksburg, VA 24060-2706
Phone
(540) 961-8300
Fax
(540) 961-8465
NPI assigned
Aug 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904012889 VA Primary

Addresses

Primary practice location

700 University City Blvd
Blacksburg, VA 24060-2706

Mailing address

700 University City Blvd
Blacksburg, VA 24060-2706
Phone (540) 961-8300

Other names 1

  • Kelli Lynch Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20210920000975 VA Practitioner - Clinical Social Worker 4789633009 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New River Valley Community Services CurrentSince Jun 12, 2021 Accepting new patients
New River Valley Community Services CurrentSince Jun 12, 2021 Accepting new patients

Locations

700 University City Blvd
Blacksburg, VA 24060
Phone (540) 961-8300

705 Wenonah Ave
Pearisburg, VA 24134
Phone (540) 921-2238

327 N Washington Ave
Pulaski, VA 24301
Phone (540) 994-5023

401 W Main St
Radford, VA 24141
Phone (540) 838-8000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1942974001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 UNIVERSITY CITY BLVD",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240602706",
            "telephone_number": "540-961-8300",
            "fax_number": "540-961-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 UNIVERSITY CITY BLVD",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240602706",
            "telephone_number": "540-961-8300",
            "fax_number": "540-961-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH-O'BRIEN",
        "first_name": "KELLI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "LYNCH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.