Active NPI
Michlle Kelly
- Behavior Analyst
- Lancaster, MA
National Provider Identifier
1053739664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 222Q000X
- Practice address
- 224 Mill Street Ext
Lancaster, MA 01523-2004 - Phone
- (978) 503-9534
- NPI assigned
- Apr 1, 2014
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 222Q000X | MA | Primary |
Addresses
Primary practice location
224 Mill Street Ext
Lancaster, MA 01523-2004
Mailing address
224 Mill Street Ext
Lancaster, MA 01523-2004
Phone (978) 503-9534
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 |
|---|---|---|---|
| 222Q000X | MA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396310400000",
"number": "1053739664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 MILL STREET EXT",
"city": "LANCASTER",
"state": "MA",
"postal_code": "015232004",
"telephone_number": "978-503-9534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 MILL STREET EXT",
"city": "LANCASTER",
"state": "MA",
"postal_code": "015232004",
"telephone_number": "978-503-9534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MICHLLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-01",
"last_updated": "2014-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "222Q000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.