Kellilynn Bosak, LCSW
NPI 1205363421ActiveIndividual· Social Worker, Clinical· Coos Bay, OR
Social Worker, Clinical (LCSW) in Coos Bay, Oregon, licensed in OR and IL, with an NPI issued in May 2017. Medicare paid $3,659 for services to 54 patients in 2024.
Overview
| NPI | 1205363421 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | No |
| NPI issued | May 18, 2017 |
| Last updated in NPPES | Nov 6, 2025 |
| Certified by provider | Nov 6, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | L8472 | OR |
| Social Worker, Clinical | 1041C0700X | 149019376 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (IL); Practitioner - Clinical Social Worker (OR) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 54 |
|---|---|
| Services billed | 105 across 7 procedure codes |
| Paid by Medicare | $3,659 |
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All 40 clinical social workers in Coos Bay · All clinical social workers in Oregon