Individual provider Active NPI

Kelly Leedy, LISW-S

  • Clinical Social Worker
  • Beachwood, OH
National Provider Identifier
1982288858
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1901753 Issued in OH
Practice address
3601 Green Rd Ste 206
Beachwood, OH 44122-5719
Phone
(216) 435-1517
NPI assigned
May 7, 2021
Last updated
Sep 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.1901753 OH Primary

Addresses

Primary practice location

3601 Green Rd Ste 206
Beachwood, OH 44122-5719

Mailing address

4370 Silsby Rd
University Heights, OH 44118-3937
Phone (216) 435-1517

Other practice location 1

620 E Broad St
Columbus, OH 43215-4037
Phone (614) 914-6690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211015000460 OH Practitioner - Clinical Social Worker 1850799222 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1901753OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Bridges Therapy and Wellness Clinical CurrentSince Sep 8, 2025 Accepting new patients
Optum Behavioral Care of Ohio, Inc Current Accepting new patients
Optum Behavioral Care of Ohio, Inc. Clinical CurrentSince Apr 1, 2024 Accepting new patients
Optum Behavioral Care of Ohio, Inc CurrentSince Apr 1, 2024 Accepting new patients
Optum Behavioral Care of Ohio, Inc Past Accepting new patients

Locations

23811 Chagrin Blvd
Ste 116
Beachwood, OH 44122
Phone (216) 282-6432

3601 Green Rd
Ste 206
Beachwood, OH 44122

4624 Sawmill Rd
Columbus, OH 43220
Phone (614) 456-4490

620 E Broad St
Ste 301
Columbus, OH 43215
Phone (614) 674-6076

Interoperability endpoints

  • Direct secure messaging: kelly.leedy.1@28621.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1982288858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 SILSBY RD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441183937",
            "telephone_number": "216-435-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 GREEN RD STE 206",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225719",
            "telephone_number": "216-435-1517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154037",
            "country_code": "US",
            "telephone_number": "614-914-6690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEEDY",
        "first_name": "KELLY",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.