Active NPI
Linda J Kelly, LCSW
- Social Worker
- Bend, OR
National Provider Identifier
1972947596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- L321
- Practice address
- 1885 NE Purcell Blvd
Bend, OR 97701-6022 - Phone
- (541) 706-2700
- Fax
- (541) 516-3877
- NPI assigned
- Apr 25, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | L321 | OR | Primary |
Addresses
Primary practice location
1885 NE Purcell Blvd
Bend, OR 97701-6022
Mailing address
PO Box 5579
Bend, OR 97708-5579
Phone (541) 706-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L321 | OR | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366848000000",
"number": "1972947596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5579",
"city": "BEND",
"state": "OR",
"postal_code": "977085579",
"telephone_number": "541-706-2700",
"fax_number": "541-516-3877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1885 NE PURCELL BLVD",
"city": "BEND",
"state": "OR",
"postal_code": "977016022",
"telephone_number": "541-706-2700",
"fax_number": "541-516-3877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "LINDA",
"middle_name": "J",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-25",
"last_updated": "2013-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OR",
"license": "L321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.