KELLY FALLON (MSW, LISW-S, LCSW) – Clinical Social Worker, NPI 1194119941

KELLY FALLON (MSW, LISW-S, LCSW) is a healthcare provider. based in Cincinnati, Ohio. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW, LISW-S, LCSW. They hold a License No. 254010 (KY). The NPI Number for KELLY FALLON (MSW, LISW-S, LCSW) is 1194119941

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
KELLY FALLON (MSW, LISW-S, LCSW)
NPI
1194119941
Phone
(513) 771-7239
Address
11590 CENTURY BLVD STE 116
Enumeration Date
18 March 2015
Last Update Date
18 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8888300347
Graduation Year
2009 (17 years ago)
PAC ID
8224441803
Group Practice PAC ID
3476606252
Professional Enrollment ID
I20220815001465
Address ID
OH450147205FA1251XRDXX307
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:11State licenses:2Digital endpointsOther names

2,650 CLINICAL SOCIAL WORKER in OH

Provider Addresses for KELLY FALLON (MSW, LISW-S, LCSW)

  • 11590 CENTURY BLVD STE 116

    CINCINNATI, OH 452463317

    Phone: (513) 771-7239

    Type: Location

  • 8665 TUDOR CT

    CINCINNATI, OH 452427836

    Phone: (513) 771-7239

    Type: Mailing

  • 4220 HOUSTON RD

    ERLANGER, KY 410183402

    Phone: (502) 262-2887

    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: 2022-08-15

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
I20220815001465IClinical 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 45246)

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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: 3476606252View full group profile
NameSpecialtyState
Mental Health CounselorOH
Mental Health CounselorOH
Mental Health CounselorCO
Clinical Social WorkerOH
Mental Health CounselorOH
Clinical Social WorkerOH
Clinical Social WorkerWI
Mental Health CounselorMI
Clinical PsychologistOH
Clinical Social WorkerOH

Reviews

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Frequently asked questions

Does KELLY FALLON (MSW, LISW-S, LCSW) have a public NPI I can cite?
Public records show KELLY FALLON (MSW, LISW-S, LCSW) under NPI 1194119941.
Does the public listing show KELLY FALLON (MSW, LISW-S, LCSW) as active?
KELLY FALLON (MSW, LISW-S, LCSW)'s NPI record reflects an active status in NPPES.
What services align with KELLY FALLON (MSW, LISW-S, LCSW)'s listing?
KELLY FALLON (MSW, LISW-S, LCSW)'s public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KELLY FALLON (MSW, LISW-S, LCSW)?
KELLY FALLON (MSW, LISW-S, LCSW) is associated with Cincinnati, Ohio in the same public data insurers reference.
Who maintains KELLY FALLON (MSW, LISW-S, LCSW)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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