Kelly Stanley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

56866 Issued in TX

Practice address

1911 N Martin Luther King Jr Blvd
Waco, TX 76704-1438

Phone

(254) 313-5000

Fax

(254) 313-5099

NPI assigned

Oct 29, 2015

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1992177968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072261",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 N MARTIN LUTHER KING JR BLVD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767041438",
            "telephone_number": "254-313-5000",
            "fax_number": "254-313-5099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 S 12th St",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767011810",
            "country_code": "US",
            "telephone_number": "254-752-3451",
            "fax_number": "254-756-3133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Providence Dr",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767072261",
            "country_code": "US",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "KELLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-29",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "56866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Stake, DO
• Othniel Stanberry, OD
• Kelly Elizabeth Standley, COTA
• Ginger Stanfield
• Sue E. Stanko, MD
• Zachary Todd Stansell
• Jada Rene Stanton, LCSW
• Lauren Ann Stanton
• Emma Claire Starcher
• Patricia Caldwell Stark, RN ANP

• Clinical Social Worker in Waco, TX
• Providers in Waco, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.