Active NPI
Vicki Leigh Kellam, LICSW
- Social Worker
- Waltham, MA
National Provider Identifier
1972686202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 281 Winter St Ste 340
Waltham, MA 02451-8766 - Phone
- (617) 999-2184
- NPI assigned
- Oct 23, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 115264 | MA | |
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
281 Winter St Ste 340
Waltham, MA 02451-8766
Mailing address
281 Winter St Ste 340
Waltham, MA 02451-8766
Phone (781) 317-6009
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1303287 | Other | MA | MBHP |
| 042611055 | Other | TAX ID | |
| 1303287 | Medicaid | MA | |
| 703136 | Other | TUFTS | |
| 1004745 | Other | MA | NHP |
| 996 | Other | NETWORK HEALTH | |
| M18633 | Other | BCBS | |
| NP01332 | Other | BOSTON MED |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
281 Winter St
Suite 340
Waltham, MA 02451-8760
Phone (781) 646-0500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Edinburg Center Inc | Clinical | Current | Accepting new patients |
| Child and Family Psychological Services, PLLC | Clinical | Current | Accepting new patients |
Locations
205 Burlington Rd
Bedford, MA 01730
Phone (781) 761-5064
89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040
281 Winter St
Ste 340
Waltham, MA 02451
Phone (508) 996-3154
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": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753142400000",
"number": "1972686202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "281 WINTER ST STE 340",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024518766",
"telephone_number": "781-317-6009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "281 WINTER ST STE 340",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024518766",
"telephone_number": "617-999-2184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLAM",
"first_name": "VICKI",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2025-07-22",
"certification_date": "2025-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "115264",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MBHP",
"identifier": "1303287",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "042611055",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1303287",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "703136",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP",
"identifier": "1004745",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "996",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "M18633",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOSTON MED",
"identifier": "NP01332",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.