Mary Anne Kelly, MFT, CDE
Individual provider Active NPI Marriage & Family Therapist · Piedmont, CA
NPI 1003036583 · NPPES record last updated Jan 27, 2016
Key facts
- NPI
- 1003036583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- MFC12717 (CA)
- Practice address
- 105 Sunnyside Ave
Piedmont, CA 94611-4419 - Phone
- (510) 655-7943
- NPI assigned
- Apr 26, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC12717 | CA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC12717 | CA | Yes |
Addresses
Primary practice location
105 Sunnyside Ave
Piedmont, CA 94611-4419
Mailing address
105 Sunnyside Ave
Piedmont, CA 94611-4419
Phone (510) 655-7943
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MFC12717 | Other | CA | MFCC LICENSE |
Other providers in Piedmont, CA
- Carlos B Johnson
- Cindy Ann Kahan
- Erik Vincent Kahn
- Cynthia G Kane
- Rachel Faye Kaplan
- Kids Overcoming, LLC
- Kidsovercoming LLC
- Alexander Klein
- Genevieve Klyce
- Brian K Kozono
All providers in Piedmont, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.