WILLIAM NATHANIEL KELLY III (NPI# 1881025302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881025302 |
| Entity Type | Individual |
| Full Name | WILLIAM NATHANIEL KELLY III |
| Credential | LCSW |
| Practice Address |
4205 Park Blvd San Diego CA 92103-2512 |
| Mailing Address |
1823 48th St San Diego CA 92102-1326 |
| Practice Telephone | 6195007088 |
| Practice Fax Number | 6193144252 |
| Mailing Telephone | 8034677385 |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2020-09-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
12866 | SC | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
C011880 | NC | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
86426 | CA | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
15681 | MD | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1145 Sturgis Street, Twentynine Palms, CA 92278 | 7608302724 | |
| 34800 Bob Wilson Dr, San Diego, CA 92134 | 6195325882 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770138018 | William Ayers Kelly Iv | Specialist/Technologist | 1520 Hurst St, Fort Bragg, NC 28308 | 2019-08-05 |
| 1629574637 | William James Kelly | Nurse Practitioner | 590 George St, New Brunswick, NJ 08901-8531 | 2018-03-30 |
| 1548392822 | William J. Kelly | Counselor | 22 Oak Tree Dr, N Kingstown, RI 02852-2035 | 2007-03-12 |
| 1699804567 | William Charles Kelly | Dentist | 42448 Cherry Hill, Canton, MI 48187 | 2007-03-05 |
| 1548351372 | William Huske Kelly | Pediatrics | 1606 Morganton Rd, Fayetteville, NC 28305-4738 | 2006-09-27 |
| 1013015908 | William J Kelly | Psychologist | 343 S 3rd St, Coopersburg, PA 18036-2111 | 2006-09-21 |
| 1194766394 | William Francis Kelly | Physician Assistant | 5100 Buckeystown Pike, Suite 186, Frederick, MD 21704-8336 | 2006-06-09 |
| 1689649402 | William James Kelly | Chiropractor | 160 Sunset Manor Dr, Birdsboro, PA 19508-1018 | 2006-02-23 |
| 1730170374 | William Sherwood Kelly | Family Medicine | 420 W Mountain St, Kernersville, NC 27284-2534 | 2005-11-02 |
| 1811525058 | William Hugh Kelly II | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2020-04-01 |
| Street Address |
4205 PARK BLVD |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920536 | Gillian Boyd | Social Worker | 3147 Eel Alley Building 271, Room 106, San Diego, CA 92136-0001 | 2020-10-18 |
| 1194338087 | Courage Over Comfort Counseling Licensed Clinical Social Worker PC | Social Worker | 4283 El Cajon Blvd Ste 226, San Diego, CA 92105-1289 | 2020-08-28 |
| 1619580057 | Joseph Stephen Mcconico | Social Worker | 5274 Mount Alifan Dr, San Diego, CA 92111-2621 | 2020-08-25 |
| 1821600529 | David James Prince | Social Worker | 1498 13th Street Bldg 184, San Diego, CA 98132 | 2020-08-24 |
| 1407467392 | Tyler Drew Willis | Social Worker | 4665 Voltaire St, San Diego, CA 92107-1762 | 2020-08-13 |
| 1174132575 | Sarah Greenstein | Social Worker | 11860 Carmel Creek Rd, San Diego, CA 92130-2474 | 2020-07-31 |
| 1730798190 | Joelle G Johnson | Social Worker | 4904 Mansfield St, San Diego, CA 92116-1936 | 2020-07-30 |
| 1881203503 | Micheaela Whaley | Social Worker | 4417 30th St Ste 112, San Diego, CA 92116-4284 | 2020-07-28 |
| 1033737812 | Clara Loginov | Social Worker | 6727 Mohawk St, San Diego, CA 92115-1642 | 2020-07-08 |
| 1780208553 | Ai-nhat Ngo | Social Worker | 9360 Activity Rd Ste B, San Diego, CA 92126-4410 | 2020-06-07 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.