Kimberly D. Kelly, LCSW, DSW
NPI 1336857028ActiveIndividual· Social Worker· Ponca City, OK
Social Worker (LCSW, DSW) with Grand Lake Mental Health Center, Inc., practicing in Ponca City, Oklahoma. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1336857028 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW, DSW |
| Sole proprietor | No |
| NPI issued | Nov 10, 2022 |
| Last updated in NPPES | Nov 10, 2022 |
| Certified by provider | Nov 10, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | 8566 | OK |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (OK) |
|---|
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
Medical group
- Grand Lake Mental Health Center, Inc.Tulsa, OK · 127 clinicians
Other Social Worker providers in Ponca City
- 1164972832
- 1801510623
- 1770991614
- 1891193280
- 1710385257
- 1497292940
- 1528470226
- 1831547827
- 1578947875
- 1407395494
- 1326531815
- 1609321330