Kelly Marie Pack, MSW, LISW-S

Primary specialty

CounselorTaxonomy code 101Y00000X

License

I0007769 Issued in OH

Practice address

270 Sterkel Blvd
Mansfield, OH 44907-1508

Phone

(419) 756-1133

NPI assigned

May 3, 2007

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268697600000",
    "number": "1972725448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6815 COUNTY ROAD 37",
            "address_2": "PO BOX 9166",
            "city": "LEXINGTON",
            "state": "OH",
            "postal_code": "449049694",
            "telephone_number": "419-362-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 STERKEL BLVD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071508",
            "telephone_number": "419-756-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2010-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "I0007769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Owens
• Megan Nicole Owens
• Patricia Owens
• Oyster Home Care Services LLC
• Shannon Marie Oyster, CRNA
• Pradyumna Kumar Padival, M.D.,F.A.C.C.
• Hannah Leigh Paeth
• Tania Pagan Carbone
• Terina Pagani
• Dana Lynn Page

• Counselor in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.