Gary Bernard Kelley, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

2187 Issued in OH

Practice address

6605 Limberlost CT
Solon, OH 44139-3100

Phone

(449) 349-5445

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1013028653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 391662",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441398662",
            "telephone_number": "449-349-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 LIMBERLOST CT",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441393100",
            "telephone_number": "449-349-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "GARY",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "2187",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "2187",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "2187",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OH",
            "license": "2187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0320996",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Katz
• Laura Elizabeth Kaufman, M.A., CCC-SLP
• Amandeep Kaur
• Nathan Keene
• Nicole Alana Kehres, M.S.
• Carol Kelly
• Kelsey Kempton, PT DPT
• Timothy Jacob Keyes Jr., D.C.
• Sadiq K Khaja Abdul, PT, DPT
• Shereif Khalil, M.D.

• Counseling Psychologist in Solon, OH
• Providers in Solon, OH by specialty
• Counseling Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.