GINNY LYNN KELLY (LICSW) – Clinical Social Worker, NPI 1619980992

GINNY LYNN KELLY (LICSW) is a healthcare provider. based in Lakeville, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 1028860 (MA). The NPI Number for GINNY LYNN KELLY (LICSW) is 1619980992

Main info

Female
31 Years Of Experience
Accepts Medicare Assignment
Name
GINNY LYNN KELLY (LICSW)
NPI
1619980992
Phone
(508) 947-1683
Address
104 CHARLES ELDRIDGE DR
Enumeration Date
15 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5089471683
Graduation Year
1995 (31 years ago)
PAC ID
5991787871
Group Practice PAC ID
9032191978
Professional Enrollment ID
I20070815000659
Address ID
MA023471864LA6XXXXLNXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,194 CLINICAL SOCIAL WORKER in MA

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Provider Addresses for GINNY LYNN KELLY (LICSW)

  • 104, Charles Eldridge Drive, Lakeville, Plymouth County, Massachusetts, 02349, United States

    LAKEVILLE, MA 02347

    Phone: (508) 947-1683

    Fax: (508) 947-1684

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-08-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070815000659IClinical Social WorkerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02347)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032191978View full group profile
NameSpecialtyState
Clinical Social WorkerMA

Reviews

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Frequently asked questions

How do I look up GINNY LYNN KELLY (LICSW) by NPI?
Use NPI 1619980992 when you need to reference GINNY LYNN KELLY (LICSW) in forms, claims, or directories.
Is GINNY LYNN KELLY (LICSW) active in the national directory?
GINNY LYNN KELLY (LICSW)'s public NPI profile is in an active state.
What kind of provider is GINNY LYNN KELLY (LICSW)?
The page reflects Clinical Social Worker for GINNY LYNN KELLY (LICSW). Clinical services aligned with this taxonomy classification.
What location shows for GINNY LYNN KELLY (LICSW)?
We surface Lakeville, Massachusetts for GINNY LYNN KELLY (LICSW) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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