KELLY GROSS (LISW) – Clinical Social Worker, NPI 1487141172

KELLY GROSS (LISW) is a healthcare provider. based in Van wert, Ohio. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LISW. They hold a License No. I.2304353 (OH). The NPI Number for KELLY GROSS (LISW) is 1487141172

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
KELLY GROSS (LISW)
NPI
1487141172
Phone
(419) 238-1695
Address
PO BOX 150
Enumeration Date
18 April 2018
Last Update Date
15 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2021 (5 years ago)
PAC ID
7012420367
Group Practice PAC ID
3971880121
Professional Enrollment ID
I20250630003043
Address ID
OH458221736CE401XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:8State licenses:1Digital endpointsOther names

2,650 CLINICAL SOCIAL WORKER in OH

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Provider Addresses for KELLY GROSS (LISW)

  • PO BOX 150

    VAN WERT, OH 458910150

    Phone: (419) 238-1695

    Fax: (419) 238-1007

    Type: Mailing

  • Marsh Foundation School, 1229, Lincoln Highway, Van Wert, Van Wert County, Ohio, 45891, United States

    VAN WERT, OH 458911877

    Phone: (419) 238-1695

    Fax: (419) 238-1007

    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: 2025-06-30

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
I20250630003043IClinical 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 45891)

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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: 3971880121View full group profile
NameSpecialtyState
Clinical Social WorkerOH
Mental Health CounselorOH
Clinical Social WorkerOH
Clinical Social WorkerOH
Mental Health CounselorOH
Clinical Social WorkerOH
Mental Health CounselorOH
Clinical Social WorkerOH
Mental Health CounselorOH
Mental Health CounselorOH

Reviews

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Frequently asked questions

What is the 10-digit NPI for KELLY GROSS (LISW)?
KELLY GROSS (LISW) — NPI 1487141172 — is the standard way to identify this listing.
Is KELLY GROSS (LISW) still practicing?
KELLY GROSS (LISW) is currently listed as active in the public NPI registry.
What healthcare role does KELLY GROSS (LISW) hold?
Scheduling teams often label KELLY GROSS (LISW) under Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What address line appears for KELLY GROSS (LISW)?
KELLY GROSS (LISW)'s geographic hint is Van Wert, Ohio in our summary view.
Is the information about KELLY GROSS (LISW) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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