MS. SHANNON MARIE KELLY LCSW
NPI 1205187788
Social Worker in Ventura, CA

Q: What is Shannon Kelly's NPI number?

The NPI number for Shannon Kelly is 1205187788. It was assigned to this individual provider in the NPPES registry on September 25, 2012.

Q: What is Shannon Kelly's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Kelly was last updated on March 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 September 25, 2012PECOS Enrolled

200 S WELLS RD STE 250, VENTURA, CA 93004(805) 647-0991(805) 647-7163 Get Directions Write a Review

NPPES record last updated: March 7, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Ms. Shannon Marie Kelly Lcsw NPPES

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

MS. SHANNON MARIE KELLY LCSW (NPI 1205187788) is an individual social worker in Ventura, California, licensed in California (LCSW75222) and active in the NPI registry since September 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205187788

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameMS. SHANNON MARIE KELLYCredential: LCSW

Location Address200 S WELLS RD STE 250Ventura, CA 93004-1383

Mailing Address1040 Flynn RdCamarillo, CA 93012-5092 · (805) 673-3930 · Fax (805) 659-3217

Phone(805) 647-0991

Fax(805) 647-7163

Sole ProprietorNo

Enumeration DateSeptember 25, 2012

Last NPPES UpdateMarch 7, 2019

✔ NPI 1205187788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in CA · LCSW75222

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

200 S WELLS RD STE 250, Ventura, CA 93004

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Shannon Marie Kelly Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 6

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

ANAMARIA SCHMID

Social Worker (Clinical)