MS. JENNIFER M. KELLY (LICSW) – Clinical Social Worker, NPI 1609070259

MS. JENNIFER M. KELLY (LICSW) is a healthcare provider. based in Omaha, Nebraska. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 1432 (NE). The NPI Number for MS. JENNIFER M. KELLY (LICSW) is 1609070259

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
MS. JENNIFER M. KELLY (LICSW)
NPI
1609070259
Phone
(402) 506-9127
Address
7100 W CENTER RD
Enumeration Date
14 June 2007
Last Update Date
12 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4028981113
Graduation Year
1998 (28 years ago)
PAC ID
1658472089
Group Practice PAC ID
3779811989
Professional Enrollment ID
I20221114002352
Address ID
NE681549603OM11404RDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

315 CLINICAL SOCIAL WORKER in NE

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Provider Addresses for MS. JENNIFER M. KELLY (LICSW)

  • West Center Road, Millard, Omaha, Douglas County, Nebraska, 68130, United States

    OMAHA, NE 681062714

    Phone: (402) 506-9127

    Fax: (402) 315-2707

    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: 2022-11-14

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
I20221114002352IClinical Social WorkerNETBD

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 68106)

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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: 3779811989View full group profile
NameSpecialtyState
Nurse PractitionerNE
Nurse PractitionerNE
Nurse PractitionerNE
Nurse PractitionerNE
Nurse PractitionerNE
Nurse PractitionerNE
Nurse PractitionerNE

Reviews

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Frequently asked questions

What federal number belongs to MS. JENNIFER M. KELLY (LICSW)?
The federal identifier for MS. JENNIFER M. KELLY (LICSW) is NPI 1609070259.
Is MS. JENNIFER M. KELLY (LICSW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MS. JENNIFER M. KELLY (LICSW)'s specialty in plain language?
Clinically, the directory lists MS. JENNIFER M. KELLY (LICSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is MS. JENNIFER M. KELLY (LICSW)'s primary listing?
We display Omaha, Nebraska because that is what the record indicates for MS. JENNIFER M. KELLY (LICSW).
What if Omaha, Nebraska seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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