MRS. JUDITH CLAIRE KELLY LCSW, CSAT
NPI 1700093317
Social Worker - Clinical in Roseville, CA

Q: What is Judith Kelly's NPI number?

The NPI number for Judith Kelly is 1700093317. It was assigned to this individual provider in the NPPES registry on May 16, 2007.

Q: What is Judith Kelly's specialty?

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

Q: Is Judith Kelly enrolled in Medicare?

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

Q: When was this NPI record last updated?

The NPPES record for Judith Kelly was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 May 16, 2007Opted out of Medicare · through Apr 1, 2028

411 OAK ST, ROSEVILLE, CA 95678(916) 783-3420(916) 771-5263 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Mrs. Judith Claire Kelly Lcsw, Csat NPPES

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

MRS. JUDITH CLAIRE KELLY LCSW, CSAT (NPI 1700093317) is an individual clinical provider in Roseville, California, licensed in California (LCS15222) and active in the NPI registry since May 2007. She has opted out of Medicare through April 1, 2028.

NPPES Registry Identity

NPI1700093317

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMRS. JUDITH CLAIRE KELLYCredential: LCSW, CSAT

Location Address411 OAK STRoseville, CA 95678-2618

Mailing Address4082 Muirwood LnRoseville, CA 95747-9796 · (916) 771-0405 · Fax (916) 771-5263

Phone(916) 783-3420

Fax(916) 771-5263

Sole ProprietorYes

Enumeration DateMay 16, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1700093317 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 CA · LCS15222

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.

411 OAK ST, Roseville, CA 95678

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Judith Claire Kelly Lcsw, Csat 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 April 1, 2024 through April 1, 2028.

Opt-Out Effective DateApril 1, 2024

Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 5

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

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