ABIGAIL KELLEY (MSW, LICSW) – Clinical Social Worker, NPI 1992041222

ABIGAIL KELLEY (MSW, LICSW) is a healthcare provider. based in Brooklyn park, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW, LICSW. They hold a License No. 19973 (MN). The NPI Number for ABIGAIL KELLEY (MSW, LICSW) is 1992041222

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
ABIGAIL KELLEY (MSW, LICSW)
NPI
1992041222
Phone
(763) 488-4084
Address
8500 EDINBROOK PKWY
Enumeration Date
13 December 2012
Last Update Date
11 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7635758086
Graduation Year
2009 (17 years ago)
PAC ID
0840444865
Group Practice PAC ID
6608192083
Professional Enrollment ID
I20130129000043
Address ID
MN553744663RO14000BLVD301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for ABIGAIL KELLEY (MSW, LICSW)

  • 8500 EDINBROOK PKWY

    BROOKLYN PARK, MN 55443

    Phone: (763) 488-4084

    Type: Location

  • 1930 COON RAPIDS BLVD NW

    COON RAPIDS, MN 554334708

    Phone: (763) 427-7964

    Type: Mailing

  • 14115 JAMES RD

    STE 305

    ROGERS, MN 553749417

    Phone: (763) 427-7964

    Type: Mailing

  • 1930 Coon Rapids Blvd NW

    Coon Rapids, MN 554334708

    Phone: (763) 427-7964

    Type: Location

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: 2013-01-29

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
I20130129000043IClinical Social WorkerMNTBD

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 55443)

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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: 6608192083View full group profile
NameSpecialtyState
Marriage And Family TherapistMN
Mental Health CounselorND
Clinical Social WorkerMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

Is there an official ID for ABIGAIL KELLEY (MSW, LICSW) in U.S. healthcare records?
The official identifier for ABIGAIL KELLEY (MSW, LICSW) is NPI 1992041222.
Is ABIGAIL KELLEY (MSW, LICSW) still an active registrant?
ABIGAIL KELLEY (MSW, LICSW) carries an active NPI according to the public dataset.
What clinical focus is listed for ABIGAIL KELLEY (MSW, LICSW)?
At a glance, ABIGAIL KELLEY (MSW, LICSW) is tied to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is ABIGAIL KELLEY (MSW, LICSW) located near Brooklyn Park?
ABIGAIL KELLEY (MSW, LICSW) currently maps to Brooklyn Park, Minnesota in this extract.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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