Active NPI
Mary Lou Kelley, PH.D.
- Clinical Psychologist
- Baton Rouge, LA
National Provider Identifier
1003943937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 519
- Practice address
- 7936 Wrenwood Blvd Ste B
Baton Rouge, LA 70809-7701 - Phone
- (225) 925-2036
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 519 | LA | Primary |
Addresses
Primary practice location
7936 Wrenwood Blvd Ste B
Baton Rouge, LA 70809-7701
Mailing address
7936 Wrenwood Blvd Ste B
Baton Rouge, LA 70809-7701
Phone (225) 925-2036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 519 | LA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Psychology Clinic | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Baton Rouge, LA
- NPI 1851428791
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003943937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7936 WRENWOOD BLVD STE B",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708097701",
"telephone_number": "225-925-2036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7936 WRENWOOD BLVD STE B",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708097701",
"telephone_number": "225-925-2036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "MARY",
"middle_name": "LOU",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "LA",
"license": "519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.