KELLY C HUMBLE LICSW
NPI 1285202853
Social Worker - Clinical in Minneapolis, MN

Q: What is Kelly Humble's NPI number?

The NPI number for Kelly Humble is 1285202853. It was assigned to this individual provider in the NPPES registry on June 11, 2021.

Q: What is Kelly Humble'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 Humble was last updated on April 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 June 11, 2021PECOS EnrolledAccepts Medicare Assignment

2810 NICOLLET AVE, MINNEAPOLIS, MN 55408(612) 873-6963 Get Directions Write a Review

NPPES record last updated: April 30, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 30, 2024, Jun 11, 2021 (2 updates tracked since 2021).

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About Kelly C Humble Licsw NPPES

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

KELLY C HUMBLE LICSW (NPI 1285202853) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (27214) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Minneapolis, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1285202853

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameKELLY C HUMBLECredential: LICSW

Location Address2810 NICOLLET AVEMinneapolis, MN 55408-4708

Mailing Address701 Park AveMinneapolis, MN 55415-1623 · (612) 873-3000

Phone(612) 873-6963

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJune 11, 2021

Last NPPES UpdateApril 30, 20242 updates tracked since enumeration

NPPES CertifiedApril 30, 2024

✔ NPI 1285202853 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 MN · 27214

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.

2810 NICOLLET AVE, Minneapolis, MN 55408

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Secondary Practice Location 1

Location 1701 Park AveMinneapolis, MN 55415-1623 · Phone (612) 873-3000

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 C Humble Licsw 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 ID9032577259

PECOS Enrollment IDI20230621000926

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 55408 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 $56.00 – $168.28

Typical copayment $0.00 (range $14.00 – $42.07)

Most-billed visit code NA

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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.

DR. SADHANA VANKA MD

Family Medicine