Kelly Lee, LISW-S, LICDC
Individual provider Active NPI Clinical Social Worker · Zanesville, OH
NPI 1972049203 · NPPES record last updated Dec 5, 2018
Key facts
- NPI
- 1972049203
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I.1600353-SUPV (OH)
- Practice address
- 1127 W Main St
Zanesville, OH 43701-3147 - Phone
- (740) 455-1266
- NPI assigned
- Jan 10, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 17
Medicare Care Compare profile
- 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 Inc
Muskingum Valley Health Centers
Practice addresses (Care Compare)
1127 W Main St
Zanesville, OH 43701-3147
Phone (740) 454-1266
716 Adair Ave
Zanesville, OH 43701-2836
Phone (740) 891-9000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190104001520 | OH | Practitioner - Clinical Social Worker | 3375828114 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LICDC.161384 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Muskingum Valley Health Centers | Current |
Accepting new patients | |
| Muskingum Valley Health Centers | Current |
Accepting new patients | |
| Muskingum County Drug Alcohol & Substance Abuse Council Inc | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
Locations
1330 Clark St
Cambridge, OH 43725
Phone (740) 421-9530
316 Clark St
Cambridge, OH 43725
Phone (740) 432-7600
440 Browns Ln
Coshocton, OH 43812
Phone (740) 295-3331
450 Downtowner Plz
Coshocton, OH 43812
Phone (740) 487-3110
406 S 15th St
Coshocton, OH 43812
Phone (740) 295-3331
1205 Cambridge Rd
#100
Coshocton, OH 43812
Phone (740) 622-9433
859 N Main St
Malta, OH 43758
Phone (740) 962-6111
716 Adair Ave
Zanesville, OH 43701
Phone (740) 454-5239
33 S 5th St
Zanesville, OH 43701
Phone (407) 891-9000
1127 W Main St
Zanesville, OH 43701
Phone (740) 454-1266
2725 Pinkerton Ln
Zanesville, OH 43701
Phone (740) 487-3348
915 Putnam Ave
Zanesville, OH 43701
Phone (407) 891-9000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LICDC.161384 | OH | |
| Clinical Social Worker | 1041C0700X | I.1600353-SUPV | OH | Yes |
Addresses
Primary practice location
1127 W Main St
Zanesville, OH 43701-3147
Mailing address
1127 W Main St
Zanesville, OH 43701-3147
Phone (740) 454-1266
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0201681 | Medicaid | OH |
Other providers in Zanesville, OH
- Elizabeth Lear
- Danielle Kay Leasure
- Lauda Maria Leavitt
- Anh-Dao Laura Son Lee
- Erin Lee
- Mikayla Sue Ann Lee
- Netria Nicole Lee
- Bethanne W Leffel-Ployhar
- Legacies at Home LLC
- Jacqueline Leighton
All providers in Zanesville, OH · Clinical Social Worker in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.