Individual ProviderKelly Ann Marie PullenSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1100 E Market St, Louisville, KY 40206-1838(502) 596-1217(502) 802-5205PECOS EnrollmentBased on the most recent information from CMS, provider Kelly Ann Marie Pullen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1912215070Provider TypeIndividualFull NamePullen, Kelly Ann MarieTitleMrs.CredentialMSSW, LCSWGenderFemaleSole ProprietorYesEnumeration Date9/22/2010Last Updated3/17/2018Contact InformationPractice LocationPractice Address1100 E Market St, Louisville, KY 40206-1838Phone(502) 596-1217FaxUnlisted FaxMailing LocationMailing Address2411 Branning Rd, Louisville, KY 40222-6228Phone(502) 802-5205FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense3745KentuckyCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense5827KentuckyProvider IdentifiersIDDescriptionIssuerID7100303920DescriptionMedicaidIssuerUnlistedKentucky