KELLY L KELLERMAN LCSW
NPI 1073534384
Social Worker - Clinical in Charlotte, NC

Q: What is Kelly Kellerman's NPI number?

The NPI number for Kelly Kellerman is 1073534384. It was assigned to this individual provider in the NPPES registry on July 21, 2006.

Q: What is Kelly Kellerman'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 Kelly Kellerman was last updated on March 13, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 July 21, 2006PECOS EnrolledAccepts Medicare Assignment

5700 EXECUTIVE CENTER DR, SUITE 110, CHARLOTTE, NC 28212(704) 525-3255(704) 525-0949 Get Directions Write a Review

NPPES record last updated: March 13, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Kelly L Kellerman Lcsw NPPES

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

KELLY L KELLERMAN LCSW (NPI 1073534384) is an individual clinical provider in Charlotte, North Carolina, licensed in North Carolina (C002690) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1993).

NPPES Registry Identity

NPI1073534384

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameKELLY L KELLERMANCredential: LCSW

Location Address5700 EXECUTIVE CENTER DR, SUITE 110Charlotte, NC 28212-8858

Mailing Address350 Pee Dee Ave, Suite 101Albemarle, NC 28001-4932 · (704) 986-1500 · Fax (704) 982-5279

Phone(704) 525-3255

Fax(704) 525-0949

Sole ProprietorNo

Medical School CMSOtherGraduated 1993

Enumeration DateJuly 21, 2006

Last NPPES UpdateMarch 13, 2017

✔ NPI 1073534384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in NC · C002690

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.

5700 EXECUTIVE CENTER DR, Charlotte, NC 28212

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly L Kellerman Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3375855307

PECOS Enrollment IDI20181024001629

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 28212 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 $54.12 – $165.09

Typical copayment $0.00 (range $13.53 – $41.27)

Most-billed visit code NA

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

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.

EASTERSEALS UCP

Case Management

5700 EXECUTIVE CENTER DR, SUITE 110
CHARLOTTE, NC 28212

Mecklenburg County (704) 566-6040

LATARSHA ANN STEELE LCSWA

Social Worker (Clinical)

5700 EXECUTIVE CENTER DR, STE 200
CHARLOTTE, NC 28212

Mecklenburg County (704) 330-4338

LEEANNE THOMPSON-FORTE LCSW-A

Social Worker (Clinical)

5700 EXECUTIVE CENTER DR
CHARLOTTE, NC 28212

Mecklenburg County (803) 431-1132

MRS. ERIN L CAMPBELL OTRL

Occupational Therapist

5700 EXECUTIVE CENTER DR, SUITE 115
CHARLOTTE, NC 28212

Mecklenburg County (704) 566-6040

CORNERSTONE COMMUNITY OUTREACH

Community/Behavioral Health

5700 EXECUTIVE CENTER DR, SUITE 214
CHARLOTTE, NC 28212

Mecklenburg County (704) 817-7786

TRUE BEHAVIORAL HEALTHCARE, INC.

Community/Behavioral Health

5700 EXECUTIVE CENTER DR, SUITE 216
CHARLOTTE, NC 28212

Mecklenburg County (704) 566-3460

MISS TINA RENEE GREEN LCSW-A

Social Worker (Clinical)

5700 EXECUTIVE CENTER DR
CHARLOTTE, NC 28212

Mecklenburg County (803) 614-4503

EASTERSEALS UCP NORTH CAROLINA

Community/Behavioral Health

5700 EXECUTIVE CENTER DR, SUITE 110
CHARLOTTE, NC 28212

Mecklenburg County (704) 566-6040

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 Kelly Kellerman's NPI number?

The NPI number for Kelly Kellerman is 1073534384. It was assigned to this individual provider in the NPPES registry on July 21, 2006.

Where is Kelly Kellerman located?

Kelly Kellerman practices at 5700 Executive Center Dr Suite 110, Charlotte, NC 28212. The listed phone number is (704) 525-3255.

What is Kelly Kellerman's specialty?

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

Is Kelly Kellerman enrolled in Medicare?

Yes. Kelly Kellerman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kelly Kellerman accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company, Priority Health and Providence Health Plan and 1 other insurer list Kelly Kellerman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Kellerman was last updated on March 13, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.