Individual provider Active NPI

Kathryn Kelly, LPC, CLAT

  • Professional Counselor
  • Orange, CT
National Provider Identifier
1073282299
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
006241 Issued in CT
Practice address
291 S Lambert Rd Ste 2
Orange, CT 06477-3559
Phone
(475) 414-6307
NPI assigned
Sep 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Art Therapist 221700000X 53 CT
Professional Counselor 101YP2500X 006241 CT Primary

Addresses

Primary practice location

291 S Lambert Rd Ste 2
Orange, CT 06477-3559

Mailing address

219 Fountain St Apt 10
New Haven, CT 06515-1983
Phone (203) 444-7040

Other practice location 1

219 Fountain St Apt 10
New Haven, CT 06515-1983
Phone (203) 444-7040

Other identifiers 2

IdentifierTypeStateIssuer
52OtherCTCT DPH
006241OtherCTDEPARTMENT OF PUBLIC HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122002908 CT Practitioner - Mental Health Counselor 8224480603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Art People LLCGroup PAC ID 6406208875, 2 clinicians

Practice addresses (Care Compare)

318 New Haven Ave
Suite B
Milford, CT 06460-6661
Phone (475) 414-6307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006241CTMDClinical Social Worker
6241CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Art People LLC Art Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

318 New Haven Ave
Ste B
Milford, CT 06460
Phone (203) 298-9085

291 S Lambert Rd
Ste 2
Orange, CT 06477
Phone (475) 308-1909

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1073282299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 FOUNTAIN ST APT 10",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151983",
            "telephone_number": "203-444-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 S LAMBERT RD STE 2",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773559",
            "telephone_number": "475-414-6307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 Fountain St Apt 10",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065151983",
            "country_code": "US",
            "telephone_number": "203-444-7040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KATHRYN",
        "credential": "LPC, CLAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "CT",
            "license": "53",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "006241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT DPH",
            "identifier": "52",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF PUBLIC HEALTH",
            "identifier": "006241",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CT

Sources for this page

Verify at the official NPI Registry.