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MS. DETRA KELLY LCSW-C
NPI 1982245049
Counselor - Mental Health in Salisbury, MD

Active since September 30, 2019PECOS EnrolledAccepts Medicare Assignment
540 RIVERSIDE DR STE 8, SALISBURY, MD 21801(410) 548-3333(410) 548-3341 Get Directions Write a Review

NPPES record last updated: September 30, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Detra Kelly Lcsw-c NPPES

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

MS. DETRA KELLY LCSW-C (NPI 1982245049) is an individual mental health provider in Salisbury, Maryland, licensed in Maryland (22747) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1982245049
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. DETRA KELLYCredential: LCSW-C
Location Address540 RIVERSIDE DR STE 8Salisbury, MD 21801-5352
Mailing Address540 Riverside Dr Ste 8Salisbury, MD 21801-5352 · (410) 548-3333 · Fax (410) 548-3341
Phone(410) 548-3333
Fax(410) 548-3341
Sole ProprietorYes
Medical School CMSOtherGraduated 2007
Enumeration DateSeptember 30, 2019
✔ NPI 1982245049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MD · 22747
540 RIVERSIDE DR STE 8, Salisbury, MD 21801
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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

Ms. Detra Kelly Lcsw-c 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 ID2365774163
PECOS Enrollment IDI20191029000051
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.

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.

LINDSAY ANN MARINE LCPC, CAC-AD
Counselor
540 RIVERSIDE DR STE 8
SALISBURY, MD 21801
Wicomico County (410) 548-3333
MISS ASHLEY ROCHELLE CONWAY CT-AD
Counselor (Addiction (Substance Use Disorder))
540 RIVERSIDE DR STE 8
SALISBURY, MD 21801
Wicomico County (443) 857-6947
JOY ARNOLD CT-AD
Counselor (Addiction (Substance Use Disorder))
540 RIVERSIDE DR STE 8
SALISBURY, MD 21801
Wicomico County (410) 548-3333
MRS. KAREN LEWIS-DRYDEN CT-AD
Counselor (Addiction (Substance Use Disorder))
540 RIVERSIDE DR STE 8
SALISBURY, MD 21801
Wicomico County (410) 548-3333
MRS. TAMIKA ADAMS BSW, CT-AD
Counselor (Addiction (Substance Use Disorder))
540 RIVERSIDE DR STE 8
SALISBURY, MD 21801
Wicomico County (410) 548-3333
GRACE BEAUCHAMP ADT
Counselor (Addiction (Substance Use Disorder))
540 RIVERSIDE DR STE 8
SALISBURY, MD 21801
Wicomico County (410) 548-3333
KAMLESH PUROHIT CT-AD
Counselor (Addiction (Substance Use Disorder))
540 RIVERSIDE DR STE 8
SALISBURY, MD 21801
Wicomico County (410) 548-3333

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 Detra Kelly's NPI number?

The NPI number for Detra Kelly is 1982245049. It was assigned to this individual provider in the NPPES registry on September 30, 2019.

Where is Detra Kelly located?

Detra Kelly practices at 540 Riverside Dr Ste 8, Salisbury, MD 21801. The listed phone number is (410) 548-3333.

What is Detra Kelly's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Detra Kelly enrolled in Medicare?

Yes. Detra Kelly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Detra Kelly was last updated on September 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.