Kelly Connolly, LICSW
NPI 1487381091ActiveIndividual· Social Worker· Coon Rapids, MN
Social Worker (LICSW) in Coon Rapids, Minnesota, licensed in MN, with an NPI issued in August 2022. Medicare paid $860.85 for services to 15 patients in 2024.
Overview
| NPI | 1487381091 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LICSW |
| Sole proprietor | No |
| NPI issued | Aug 3, 2022 |
| Last updated in NPPES | Jan 17, 2023 |
| Certified by provider | Jan 17, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | 25205 | MN |
| Social Worker, Clinical | 1041C0700X | 25205 | MN |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 15 |
|---|---|
| Services billed | 23 across 3 procedure codes |
| Paid by Medicare | $860.85 |
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