Individual provider · Type 1 NPI

Miranda Kelly

Clinical Social Worker · Fort Worth, TX

NPI number 1992255129 Active

Practice location

1518 E Lancaster Ave
Fort Worth, TX 76102-6774

Specialties and licenses

Taxonomy	Code	License
Clinical Social Worker Primary	1041C0700X	56207 (TX)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1992255129

Miranda Kelly's National Provider Identifier is 1992255129, issued on Oct 12, 2016. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fort Worth, TX. The record was last updated on Oct 12, 2016.