Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelly OTA, LCSW

Individual provider Clinical Social Worker · NPI 1366158925

Kelly OTA, LCSW is a Clinical Social Worker in LA Mesa, California. Licensed in California. Registered with an NPI since 2023.

Licensed in
CA
In the registry since
2023
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

5555 Grossmont Center Dr
LA Mesa, CA 91942-3019
Phone: (619) 740-4786
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 95784 (CA)

Record details

NPI number1366158925
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJanuary 26, 2023
Last updated in NPPESJanuary 26, 2023
Certification dateSeptember 5, 2021

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