Kelly Minor, LCSW
Kelly Minor, LCSW is a provider specialising in Clinical Social Worker in Jacksonville, FL, registered under NPI 1699122721. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 11266 LAKE MANDARIN CIR E, Jacksonville, FL 32223. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| SW 5779 | FL | Clinical Social Worker primary |
| 013491 | CT | Clinical Social Worker |
| 12589-123 | WI | Clinical Social Worker |
| 6801115459 | MI | Clinical Social Worker |
Licences are recorded in 4 states: FL, CT, WI, MI. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Clinical Social Worker
- PAC ID
- 5698054807
Medicare enrolment is recorded as approved under the provider type Practitioner - Clinical Social Worker. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 4 states
This provider holds licences in 4 states: Connecticut, Florida, Michigan and Wisconsin. The practice address on file is in Jacksonville, FL, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- SW 5779
- Specialty
- Clinical Social Worker
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Clinical covers
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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. NUCC Health Care Provider Taxonomy, code 1041C0700X
All registered taxonomy codes
This provider registers 4 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 1041C0700X | Clinical Social Worker Clinical | SW 5779 | FL | primary |
| 1041C0700X | Clinical Social Worker Clinical | 013491 | CT | |
| 1041C0700X | Clinical Social Worker Clinical | 12589-123 | WI | |
| 1041C0700X | Clinical Social Worker Clinical | 6801115459 | MI |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1699122721 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | May 18, 2016 |
| Last updated | May 1, 2026 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | LCSW |
| Practice address |
11266 LAKE MANDARIN CIR E Jacksonville, FL 32223 (904) 705-6130 |
| Mailing address |
7643 GATE PKWY STE 104-941 Jacksonville, FL 32256 |
| Other identifiers |
M560513595410
(FL) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 6 | 9 | 9 | 1 | 2 | 2 | 7 | 2 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 6 | 9 | 9 | 2 | 2 | 4 | 7 | 4 |
Sum = 69 · next multiple of 10 = 70 · check digit = 1 · actual last digit = 1
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.