KELLY KOHLI (LCSW) – Clinical Social Worker, NPI 1265843205

KELLY KOHLI (LCSW) is a healthcare provider. based in Bountiful, Utah. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 10371882-3501 (UT). The NPI Number for KELLY KOHLI (LCSW) is 1265843205

Main info

Female
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
KELLY KOHLI (LCSW)
NPI
1265843205
Phone
(801) 556-4751
Address
1459 N MAIN ST # 100
Enumeration Date
13 May 2014
Last Update Date
13 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8019343373
Graduation Year
2017 (9 years ago)
PAC ID
7911305966
Group Practice PAC ID
0446511927
Professional Enrollment ID
I20211006001486
Address ID
UT840144904CE520XXDRXX501
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:12State licenses:1Digital endpointsOther names

965 CLINICAL SOCIAL WORKER in UT

Provider Addresses for KELLY KOHLI (LCSW)

  • 1459 N MAIN ST # 100

    BOUNTIFUL, UT 840106092

    Phone: (801) 556-4751

    Type: Mailing

  • 934 S MAIN ST

    LAYTON, UT 840417135

    Phone:

    Type: Mailing

  • 913 N 2125 W

    LAYTON, UT 840412104

    Phone: (801) 556-4751

    Type: Mailing

  • 1544 WOODLAND PARK DR STE 320

    LAYTON, UT 840415621

    Phone: (801) 556-4751

    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: 2021-10-06

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
I20211006001486IClinical Social WorkerUTTBD

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 84010)

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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: 0446511927View full group profile
NameSpecialtyState
Clinical Social WorkerUT
Mental Health CounselorUT
-UT
-UT
Mental Health CounselorUT
N E U R O L O G YUT
Clinical Social WorkerUT
Clinical PsychologistUT
Clinical Social WorkerAZ
Clinical Social WorkerUT

Reviews

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Frequently asked questions

How do payers reference KELLY KOHLI (LCSW)?
For KELLY KOHLI (LCSW), use NPI 1265843205 as the unique 10-digit identifier.
Would KELLY KOHLI (LCSW) appear as active to a payer?
You can treat KELLY KOHLI (LCSW) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is KELLY KOHLI (LCSW)?
KELLY KOHLI (LCSW) is associated with Clinical Social Worker in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for KELLY KOHLI (LCSW)?
Travel planning: use Bountiful, Utah as the reference point for KELLY KOHLI (LCSW), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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