Terry Kelly, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

488 Issued in AK

Practice address

1716 University Ave S
Fairbanks, AK 99709-4904

Phone

(907) 322-6940

Fax

(907) 455-4434

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1053494898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80282",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997080282",
            "telephone_number": "907-322-6940",
            "fax_number": "907-455-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 UNIVERSITY AVE S",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094904",
            "telephone_number": "907-322-6940",
            "fax_number": "907-455-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TERRY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AK",
            "license": "488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lamozae Kelley I
• Kimberly Ann Kelly, PH. D., MA, MED
• Larry Wayne Kelly Jr., PMHNP
• Myra Lynn Kelly, APRN
• Staysha Kelly
• Surech Dawn Kemesong
• Elizabeth Angusta Kendall, LMT
• Samantha Dee Kennett
• Stewart M Kerr, MD
• Nathan Joseph Kessler, DO

• Professional Counselor in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Professional Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.