JACKELYN RAE KELLEY LCSW
NPI 1063837144
Social Worker - Clinical in San Francisco, CA

Q: What is Jackelyn Kelley's NPI number?

The NPI number for Jackelyn Kelley is 1063837144. It was assigned to this individual provider in the NPPES registry on February 26, 2014. The provider is also known as Jack Rae Smith.

Q: What is Jackelyn Kelley's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Jackelyn Kelley was last updated on April 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 26, 2014PECOS Enrolled

1001 POTRERO AVE, WARD 93, SAN FRANCISCO, CA 94110(724) 544-3437 Get Directions Write a Review

NPPES record last updated: April 25, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jackelyn Rae Kelley Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKELYN RAE KELLEY LCSW (NPI 1063837144) is an individual clinical provider in San Francisco, California, licensed in California (100708) and active in the NPI registry since February 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1063837144

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameJACKELYN RAE KELLEYCredential: LCSW

Location Address1001 POTRERO AVE, WARD 93San Francisco, CA 94110-3518

Mailing Address141 Oak PlPittsburg, CA 94565-3820 · (724) 544-3437

Phone(724) 544-3437

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateFebruary 26, 2014

Last NPPES UpdateApril 25, 2021

NPPES CertifiedApril 23, 2021

✔ NPI 1063837144 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in CA · 100708

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedCounselorTaxonomy 101Y00000X · License 60311 (CA)

1001 POTRERO AVE, San Francisco, CA 94110

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Other Names 1

Other Name (5)Jack Rae Smith

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackelyn Rae Kelley Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8820587314

PECOS Enrollment IDI20251025000460

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94110 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $69.00 – $202.35

Typical copayment $0.00 (range $17.25 – $50.58)

Most-billed visit code NA

Established Patient

$84.91 typical visit price

range $23.44 – $166.46

Typical copayment $21.22 (range $5.86 – $41.61)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROCIO C AGRAZ-LARA RN, PHN

Registered Nurse

1001 POTRERO AVE, ZSFG BUILDING 90 4TH FLOOR
SAN FRANCISCO, CA 94110

San Francisco County (415) 206-8524

DR. SUSAN WLODARCZYK MD

Student in an Organized Health Care Education/Training Program

1001 POTRERO AVE, BLDG 10, 3RD FLOOR, WARD 13 BOX 1364
SAN FRANCISCO, CA 94110

San Francisco County (415) 206-5164

AMY DINER PSY.D.

Student in an Organized Health Care Education/Training Program

1001 POTRERO AVE
SAN FRANCISCO, CA 94110

San Francisco County (415) 206-5270

CHRISTOPHER RUIZ

Case Manager/Care Coordinator

1001 POTRERO AVE
SAN FRANCISCO, CA 94110

San Francisco County (415) 206-3950

C. STIRLING SOMERS

Counselor

1001 POTRERO AVE
SAN FRANCISCO, CA 94110

San Francisco County (415) 206-5270

WILLIAM RUSSEL CARPENTER FNP-C

Nurse Practitioner (Family)

1001 POTRERO AVE
SAN FRANCISCO, CA 94110

San Francisco County (628) 206-8000

REGENTS OF THE UNIVERSITY OF CALIFORNIA

Clinical Medical Laboratory

1001 POTRERO AVE, BLDG 100, RM 104
SAN FRANCISCO, CA 94110

San Francisco County (415) 502-4775

DR. DENISE RENEE GONZALEZ MD

Internal Medicine

1001 POTRERO AVE, 1M
SAN FRANCISCO, CA 94110

San Francisco County (415) 206-6075

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackelyn Kelley's NPI number?

The NPI number for Jackelyn Kelley is 1063837144. It was assigned to this individual provider in the NPPES registry on February 26, 2014. The provider is also known as Jack Rae Smith.

Where is Jackelyn Kelley located?

Jackelyn Kelley practices at 1001 Potrero Ave Ward 93, San Francisco, CA 94110. The listed phone number is (724) 544-3437.

What is Jackelyn Kelley's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jackelyn Kelley enrolled in Medicare?

Yes. Jackelyn Kelley is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jackelyn Kelley was last updated on April 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.