Susan Kelly, LADC, CAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

000634 Issued in CT

Practice address

1890 Dixwell Ave
Hamden, CT 06514-3122

Phone

(860) 223-9291

Fax

(860) 223-3111

NPI assigned

Apr 14, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Family Services of Central CT, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New Britain, CT
  • NPI 1801842190
  NPD (past)

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1043484702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143122",
            "telephone_number": "860-223-9291",
            "fax_number": "860-223-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143122",
            "telephone_number": "860-223-9291",
            "fax_number": "860-223-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "LADC, CAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAC",
            "identifier": "3734",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADC",
            "identifier": "000634",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Kazdan, LCSW
• Erin Mullaney Keane, RN, PPCNP-BC
• Lynsey McGrath Keator
• Amanda Kedzior
• Gresi Kello, PA-C
• Stephanie Kelsey-Reynolds, OTR L
• Kathryn Blaney Kennedy, LPC
• Karin E Kerfoot, MD
• Marcy Ann Kesilewski, PA-C
• Janice Kessler, LCSW

• Addiction (Substance Use Disorder) Counselor in Hamden, CT
• Providers in Hamden, CT by specialty
• Addiction (Substance Use Disorder) Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.