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KELLY KOELLER LCSW
NPI 1639473465
Social Worker - Clinical in Somerville, NJ

Active since January 09, 2011Opted out of Medicare · through Oct 1, 2028
110 REHILL AVE, SOMERVILLE, NJ 08876(908) 203-5961 Get Directions Write a Review

NPPES record last updated: November 14, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kelly Koeller Lcsw NPPES

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

KELLY KOELLER LCSW (NPI 1639473465) is an individual clinical provider in Somerville, New Jersey, licensed in New Jersey (44SC05693300) and active in the NPI registry since January 2011. She has opted out of Medicare through October 1, 2028.

NPPES Registry Identity

NPI1639473465
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELLY KOELLERCredential: LCSW
Location Address110 REHILL AVESomerville, NJ 08876-2519
Mailing AddressPo Box 834Saddle River, NJ 07458-0834
Phone(908) 203-5961
Sole ProprietorNo
Enumeration DateJanuary 9, 2011
Last NPPES UpdateNovember 14, 2016
✔ NPI 1639473465 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 NJ · 44SC05693300
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.
110 REHILL AVE, Somerville, NJ 08876
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Other Names 1

Former Name (1)Kelly Hansen Lcsw

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Kelly Koeller Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2026 through October 1, 2028.

Opt-Out Effective DateOctober 1, 2026
Opt-Out In Effect ThroughOctober 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

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.

ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL INC
General Acute Care Hospital
110 REHILL AVE
SOMERVILLE, NJ 08876
Somerset County (732) 937-8537
JILLIAN NICOLE BOOSE PA-C
Physician Assistant
110 REHILL AVE
SOMERVILLE, NJ 08876
Somerset County (908) 685-2200
LETICIA ANTUNES
Physical Therapist
110 REHILL AVE
SOMERVILLE, NJ 08876
Somerset County (908) 685-2200
OSAMA ZIDAT MD
Student in an Organized Health Care Education/Training Program
110 REHILL AVE
SOMERVILLE, NJ 08876
Somerset County (908) 685-2200
LAUREN SCROCCA
Peer Specialist
110 REHILL AVE
SOMERVILLE, NJ 08876
Somerset County (908) 685-2200
JASON ISENHOUR
Peer Specialist
110 REHILL AVE
SOMERVILLE, NJ 08876
Somerset County (908) 685-2200
DAVID OH MD
Emergency Medicine
110 REHILL AVE, SOMERSET MEDICAL CENTER
SOMERVILLE, NJ 08876
Somerset County (908) 685-2833
RONALD WALTON
Peer Specialist
110 REHILL AVE
SOMERVILLE, NJ 08876
Somerset County (908) 685-2200

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 Koeller's NPI number?

The NPI number for Kelly Koeller is 1639473465. It was assigned to this individual provider in the NPPES registry on January 9, 2011. The provider is also known as Kelly Hansen Lcsw.

Where is Kelly Koeller located?

Kelly Koeller practices at 110 Rehill Ave, Somerville, NJ 08876. The listed phone number is (908) 203-5961.

What is Kelly Koeller's specialty?

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

Is Kelly Koeller enrolled in Medicare?

No. Kelly Koeller has opted out of Medicare through October 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kelly Koeller was last updated on November 14, 2016. 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.