Lawrence Everrett Kelly
Case Manager/Care Coordinator in Woodbridge, VA. Individual provider (NPI-1).
NPI number1942901293
StatusActive
Last updated in NPPESApr 14, 2023
Details
- NPI
- 1942901293
- Entity type
- Individual (NPI-1)
- Name
- Lawrence Everrett Kelly
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 14, 2023
- Certification date
- Apr 14, 2023
- Last updated
- Apr 14, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
| 106S00000X | Behavior Technician | – | – |
Practice location
15018 Carlsbad RdWoodbridge, VA 22193-1606
Phone 703-270-8403
Mailing address
15018 Carlsbad RdWoodbridge, VA 22193-1606
Phone 703-270-8403
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 15 Case Manager/Care Coordinator providers in Woodbridge · All 3,608 providers in Woodbridge
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