Kelly Lee, LISW-S, LICDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1600353-SUPV Issued in OH

Practice address

1127 W Main St
Zanesville, OH 43701-3147

Phone

(740) 455-1266

NPI assigned

Jan 10, 2017

Last updated

Dec 5, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Muskingum County Drug Alcohol and Substance Abuse Council IncGroup PAC ID 4789956236, 2 clinicians

Muskingum Valley Health CentersGroup PAC ID 4789760216, 74 clinicians

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.

• Muskingum County Drug Alcohol & Substance Abuse Council Inc

  dba Muskingum Behavioral Health

  • Addiction (Substance Use Disorder) Counselor
  • Zanesville, OH
  • NPI 1720349434
  Medicare reassignment Care Compare group NPD
• Muskingum Valley Health Centers

  • Primary Care Clinic/Center
  • Malta, OH
  • NPI 1205018348
  Medicare reassignment Care Compare group
• Muskingum Valley Health Centers

  • Primary Care Clinic/Center
  • Zanesville, OH
  • NPI 1346077708
  NPD
• Muskingum Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Zanesville, OH
  • NPI 1851285019
  NPD

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1972049203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 W MAIN ST",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437013147",
            "telephone_number": "740-454-1266",
            "fax_number": "740-454-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 W MAIN ST",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437013147",
            "telephone_number": "740-455-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KELLY",
        "credential": "LISW-S, LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-10",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161384",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600353-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Lear, PHARMD
• Danielle Kay Leasure
• Lauda Maria Leavitt, BA,QMHS
• Anh-Dao Laura Son Lee, DO
• Erin Lee
• Mikayla Sue Ann Lee
• Netria Nicole Lee
• Bethanne W Leffel-Ployhar, MSW, LISW
• Legacies at Home LLC
• Jacqueline Leighton, BCABA

• Clinical Social Worker in Zanesville, OH
• Providers in Zanesville, 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 Dec 5, 2018; 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.