MEDICARE: MRS. KELLY MARIE O'DONNELL LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW-17606	AZ

General Provider Information

NPI Number	:	1790249464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELLY MARIE O'DONNELL LCSW

Provider Business Mailing Address
First Line	:	421 N HUMPHREYS ST
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-4531
Country	:	US
Telephone Number	:	928-233-8796
Fax Number	:

Provider Business Practice Location Address
First Line	:	421 N HUMPHREYS ST
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-4531
Country	:	US
Telephone Number	:	928-233-8796
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2019
Last Update Date	:	05/04/2026

Similar Medicare Providers

1861453953 — DR. MARK ANTHONY ROSALES DPM
Practice Location Address:

421 N HUMPHREYS ST
FLAGSTAFF, AZ
86001-4531

Practice Phone: 928-774-9325
Practice Fax: 888-464-1135

1043390479 — TAMI LORRAINE YOUNG PHD
Practice Location Address:

421 N HUMPHREYS ST
FLAGSTAFF, AZ
86001-4531

Practice Phone: 928-482-2323
Practice Fax:

1447464698 — HUMPHREYS STREET CHIROPRACTIC
Practice Location Address:

421 N HUMPHREYS ST
FLAGSTAFF, AZ
86001-4531

Practice Phone: 928-774-6601
Practice Fax: 928-774-2193

1952596991 — ANTHONY ROSALES, DPM, PC
Practice Location Address:

421 N HUMPHREYS ST
FLAGSTAFF, AZ
86001-4531

Practice Phone: 928-774-4825
Practice Fax: 888-464-1135

1750794731 — DR. MICHAEL JAMES DRUSCHEL MD
Practice Location Address:

1600 W UNIVERSITY AVE STE 112
FLAGSTAFF, AZ
86001-3154

Practice Phone: 928-223-4823
Practice Fax: 202-381-9567

1205763687 — WHITLEY HARBISON KLOEBLEN
Practice Location Address:

1200 N BEAVER ST
FLAGSTAFF, AZ
86001-3118

Practice Phone: 928-779-3366
Practice Fax:

Directions to “ MRS. KELLY MARIE O'DONNELL LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.