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

Kimberly D Kelly, LCSW, DSW

Individual provider Social Worker · NPI 1336857028

Kimberly D Kelly, LCSW, DSW is a Clinical Social Worker in Ponca City, Oklahoma. Qualified in 2021, 5 years ago. Practices with Grand Lake Mental Health Center, Inc, a 120-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oklahoma.

Years since qualifying
5
Licensed in
OK
In the registry since
2022
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

407 W South Ave
Ponca City, OK 74601-6133
Phone: (580) 749-5056
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 8566 (OK)

Record details

NPI number1336857028
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW , DSW
Sole proprietorNo
NPI enumeratedNovember 10, 2022
Last updated in NPPESNovember 10, 2022
Certification dateNovember 10, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Grand Lake Mental Health Center, Inc. — 120 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Ponca City