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KELLY CONNOLLY LICSW
NPI 1487381091
Social Worker in Coon Rapids, MN

Active since August 03, 2022PECOS Enrolled
83.53/100
CMS Quality Rating
3960 COON RAPIDS BLVD NW STE 200, COON RAPIDS, MN 55433(763) 236-9236 Get Directions Write a Review

NPPES record last updated: January 17, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 17, 2023, Aug 3, 2022 (2 updates tracked since 2022).

About Kelly Connolly Licsw NPPES

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

KELLY CONNOLLY LICSW (NPI 1487381091) is an individual social worker in Coon Rapids, Minnesota, licensed in Minnesota (25205) and active in the NPI registry since August 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487381091
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameKELLY CONNOLLYCredential: LICSW
Location Address3960 COON RAPIDS BLVD NW STE 200Coon Rapids, MN 55433-2589
Mailing Address3960 Coon Rapids Blvd Nw Ste 200Coon Rapids, MN 55433-2589
Phone(763) 236-9236
Sole ProprietorNo
Enumeration DateAugust 3, 2022
Last NPPES UpdateJanuary 17, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2023
✔ NPI 1487381091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in MN · 25205
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.
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 25205 (MN)
3960 COON RAPIDS BLVD NW STE 200, Coon Rapids, MN 55433
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Connolly Licsw 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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 45 minutes 90834
Psychotherapy is a treatment method where you converse with a therapist about your thoughts, feelings, and behaviors. In a 45-minute session, the therapist assists you in understanding and managing your mental health concerns, improving emotional wellness, and promoting personal growth.
18 services14 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.53/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.79
Promoting Interoperability100
Improvement Activities40
Cost63.31

Other Providers at the Same Location NPPES 7

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

EMILY JOSEPHINE MILLER PA-C
Physician Assistant
3960 COON RAPIDS BLVD NW STE 200
COON RAPIDS, MN 55433
Anoka County (763) 236-9236
WENDY MARIE LOVAAS WHNP
Nurse Practitioner (Women's Health)
3960 COON RAPIDS BLVD NW STE 200
COON RAPIDS, MN 55433
Anoka County (763) 236-9236
CONNOR ROBERT BAKER MD
Obstetrics & Gynecology
3960 COON RAPIDS BLVD NW STE 200
COON RAPIDS, MN 55433
Anoka County (763) 236-9236
ELLE LAUREL BALIUS LICSW
Social Worker (Clinical)
3960 COON RAPIDS BLVD NW STE 200
COON RAPIDS, MN 55433
Anoka County (763) 236-9236
ABIGAIL GRACE PELLETIER LORRAINE MD, MPH
Obstetrics & Gynecology
3960 COON RAPIDS BLVD NW STE 200
COON RAPIDS, MN 55433
Anoka County (763) 236-9236
MEREDITH HUSZAGH REED M.D.
Obstetrics & Gynecology
3960 COON RAPIDS BLVD NW STE 200
COON RAPIDS, MN 55433
Anoka County (763) 236-9236
ALLINA HEALTH SYSTEM
Clinic/Center
3960 COON RAPIDS BLVD NW STE 200
COON RAPIDS, MN 55433
Anoka County (763) 236-9236

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 Connolly's NPI number?

The NPI number for Kelly Connolly is 1487381091. It was assigned to this individual provider in the NPPES registry on August 3, 2022.

Where is Kelly Connolly located?

Kelly Connolly practices at 3960 Coon Rapids Blvd NW Ste 200, Coon Rapids, MN 55433. The listed phone number is (763) 236-9236.

What is Kelly Connolly's specialty?

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

Is Kelly Connolly enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Kelly Connolly was last updated on January 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.