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KELLY LYNN DAUGHERTY LCSW-R
NPI 1265581482
Social Worker - Clinical in Malta, NY

Active since January 09, 2007PECOS Enrolled
100 SARATOGA VILLAGE BLVD STE 21, MALTA, NY 12020(518) 219-8625 Get Directions Write a Review

NPPES record last updated: September 23, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kelly Lynn Daugherty Lcsw-r NPPES

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

KELLY LYNN DAUGHERTY LCSW-R (NPI 1265581482) is an individual clinical provider in Malta, New York, licensed in New York (R077453) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1265581482
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELLY LYNN DAUGHERTYCredential: LCSW-R
Location Address100 SARATOGA VILLAGE BLVD STE 21Malta, NY 12020-3703
Mailing Address100 Saratoga Village Blvd Ste 21Malta, NY 12020-3703 · (518) 219-8625
Phone(518) 219-8625
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateJanuary 9, 2007
Last NPPES UpdateSeptember 23, 2021
NPPES CertifiedSeptember 23, 2021
✔ NPI 1265581482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in NY · R077453✔ Licensed in NC · C005397
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.
100 SARATOGA VILLAGE BLVD STE 21, Malta, NY 12020
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Other Identifiers 1

Medicaid6106466NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Lynn Daugherty Lcsw-r is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7517285976
PECOS Enrollment IDI20180112001683
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.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Daugherty reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kelly Daugherty, Lcsw, PLLC
Same address
Clinical
100 SARATOGA VILLAGE BLVD STE 21
Malta, NY 12020
  • Reassigned Medicare billing, New York enrollment
NPI 1699579730 (518) 219-8625

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12020 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 $54.87 – $166.88
Typical copayment $0.00 (range $13.71 – $41.72)
Most-billed visit code NA
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
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 2

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

MRS. CHERI ANN DAVIES LCSW-R
Social Worker (Clinical)
100 SARATOGA VILLAGE BLVD STE 21
MALTA, NY 12020
Saratoga County (518) 290-1877
KELLY DAUGHERTY, LCSW, PLLC
Social Worker (Clinical)
100 SARATOGA VILLAGE BLVD STE 21
MALTA, NY 12020
Saratoga County (518) 219-8625

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 Daugherty's NPI number?

The NPI number for Kelly Daugherty is 1265581482. It was assigned to this individual provider in the NPPES registry on January 9, 2007.

Where is Kelly Daugherty located?

Kelly Daugherty practices at 100 Saratoga Village Blvd Ste 21, Malta, NY 12020. The listed phone number is (518) 219-8625.

What is Kelly Daugherty's specialty?

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

Is Kelly Daugherty enrolled in Medicare?

Yes. Kelly Daugherty is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Daugherty's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Daugherty reassigns Medicare benefits to Kelly Daugherty, Lcsw, PLLC (Malta, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Daugherty's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Daugherty accept?

Health plans from Oscar Health and UnitedHealthcare list Kelly Daugherty 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 Daugherty was last updated on September 23, 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.