Active NPI
Kelly Gill Beth, LCSW, LICSW
- Clinical Social Worker
- Tacoma, WA
National Provider Identifier
1952468829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW60445728
- Practice address
- 9600 Veterans Dr SW
A-116-MHC
Tacoma, WA 98493-0003 - Phone
- (253) 583-2727
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 1880C | AL | |
| Clinical Social Worker | 1041C0700X | LW60445728 | WA | Primary |
Addresses
Primary practice location
9600 Veterans Dr SW
A-116-MHC
Tacoma, WA 98493-0003
Mailing address
3516 Rust St
Gig Harbor, WA 98332-2178
Phone (253) 583-2727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 273814 | Other | AL | COMPSYCH |
Other names 1
- Kelly Gill Wells
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 |
|---|---|---|---|
| 1880C | AL | MD | Counselor |
| LW60445728 | WA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adult & Adolescent Psychology Associates, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Counseling Psychologist
- Birmingham, AL
- NPI 1912073354
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588377600000",
"number": "1952468829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3516 RUST ST",
"city": "GIG HARBOR",
"state": "WA",
"postal_code": "983322178",
"telephone_number": "253-583-2727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9600 VETERANS DR SW",
"address_2": "A-116-MHC",
"city": "TACOMA",
"state": "WA",
"postal_code": "984930003",
"telephone_number": "253-583-2727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETH",
"first_name": "KELLY",
"middle_name": "GILL",
"name_prefix": "Ms.",
"credential": "LCSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2020-05-02",
"certification_date": "2020-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AL",
"license": "1880C",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW60445728",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPSYCH",
"identifier": "273814",
"state": "AL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "WELLS",
"middle_name": "GILL",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.