Martha Catherine Kelley, CSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801066694 Issued in MI

Practice address

505 Wildwood Ave
Jackson, MI 49201-1012

Phone

(517) 783-4418

Fax

(517) 783-4504

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Behavioral Wellness Center LLC

  • Counselor
  • Hillsdale, MI
  • NPI 1174281364
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972649572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 WILDWOOD AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011012",
            "telephone_number": "517-783-4418",
            "fax_number": "517-783-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 WILDWOOD AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011012",
            "telephone_number": "517-783-4418",
            "fax_number": "517-783-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MARTHA",
        "middle_name": "CATHERINE",
        "name_prefix": "Miss",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801066694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyn Kristin Kay, PH.D.
• Sydney Michelle Kay, LMSW
• Barry J Keatley, D.C.
• Robin Lucasta Keefer Brigham, PA-C
• Johanna L Keller
• Tamara Jo Kelley, NP-C
• Andrew Lee Kellogg, D.C.
• Marissa Kells, M.M., MT-BC
• Eric G Kelly, LLMSW
• Gwenda J Kelly, L.L.P.C

• All providers in Jackson, MI
• Social Worker in Michigan

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.