KELLIE JEAN DAWSON (L.I.S.W-S) – Clinical Social Worker, NPI 1053429605

KELLIE JEAN DAWSON (L.I.S.W-S) is a healthcare provider. based in Delaware, Ohio. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials L.I.S.W-S. They hold a License No. I. 0009062 SUPV (OH). The NPI Number for KELLIE JEAN DAWSON (L.I.S.W-S) is 1053429605

Main info

Female
Sole Proprietor
27 Years Of Experience
Accepts Medicare Assignment
Name
KELLIE JEAN DAWSON (L.I.S.W-S)
NPI
1053429605
Phone
(614) 946-7571
Address
21 W CENTRAL AVE
Enumeration Date
25 August 2006
Last Update Date
25 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6149467571
Graduation Year
1999 (27 years ago)
PAC ID
2769473974
Professional Enrollment ID
I20040518001074
Address ID
OH430151778DE163XXSTXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,650 CLINICAL SOCIAL WORKER in OH

Provider Addresses for KELLIE JEAN DAWSON (L.I.S.W-S)

  • 21, Central Avenue, South Chester, Chester, Delaware County, Pennsylvania, 19013, United States

    DELAWARE, OH 430151911

    Phone: (614) 946-7571

    Fax: (740) 879-2826

    Type: Mailing

  • 1725 W Central Ave

    Delaware, OH 430151699

    Phone: (740) 363-8171

    Type: Location

  • 163 N SANDUSKY ST STE 104

    DELAWARE, OH 430151778

    Phone: (614) 946-7571

    Fax: (740) 879-2826

    Type: Mailing

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: 2004-05-18

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
I20040518001074IClinical Social WorkerOHTBD

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 43015)

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Reviews

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Frequently asked questions

What is the standard ID for KELLIE JEAN DAWSON (L.I.S.W-S) in the U.S.?
In the U.S., KELLIE JEAN DAWSON (L.I.S.W-S) is identified by NPI 1053429605.
Should I treat KELLIE JEAN DAWSON (L.I.S.W-S) as an active provider?
Patients and plans typically see KELLIE JEAN DAWSON (L.I.S.W-S) as active in the national extract.
What type of care does KELLIE JEAN DAWSON (L.I.S.W-S) provide?
KELLIE JEAN DAWSON (L.I.S.W-S)'s profile centers on Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What city is tied to KELLIE JEAN DAWSON (L.I.S.W-S)?
The directory associates KELLIE JEAN DAWSON (L.I.S.W-S) with Delaware, Ohio. Check all listed addresses for suites or satellite offices.
Who maintains KELLIE JEAN DAWSON (L.I.S.W-S)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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