Active NPI
Erin Marlene Kelly, LMFT
- Marriage & Family Therapist
- Cookeville, TN
National Provider Identifier
1013420843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1135
- Practice address
- 320 E Broad St
Cookeville, TN 38501-3382 - Phone
- (931) 252-4245
- NPI assigned
- Nov 15, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1135 | TN | Primary |
Addresses
Primary practice location
320 E Broad St
Cookeville, TN 38501-3382
Mailing address
320 E Broad St
Cookeville, TN 38501-3382
Phone (931) 252-4245
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1135 | TN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510704000000",
"number": "1013420843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 E BROAD ST",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385013382",
"telephone_number": "931-252-4245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 E BROAD ST",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385013382",
"telephone_number": "931-252-4245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "ERIN",
"middle_name": "MARLENE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-15",
"last_updated": "2017-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": "TN",
"license": "1135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cookeville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.