Susan R Kelley, M.ED.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PENDING Issued in MA

Practice address

200 Ter Heun Dr
Falmouth, MA 02540-2525

Phone

(508) 540-6550

Fax

(508) 540-7480

NPI assigned

Mar 5, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

432 Intentional Therapeutics IncGroup PAC ID 3678943826, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 432 Intentional Therapeutics Inc

  dba Louisa Gould, LICSW

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mashpee, MA
  • NPI 1962121772
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093844193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 LOCUST ST",
            "city": "FALMOUTH",
            "state": "MA",
            "postal_code": "025402659",
            "telephone_number": "508-540-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TER HEUN DR",
            "city": "FALMOUTH",
            "state": "MA",
            "postal_code": "025402525",
            "telephone_number": "508-540-6550",
            "fax_number": "508-540-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SUSAN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "M.ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Von Haam MD PC
• Kimberly Katsios
• Mary A. Katz, MA LPC LMHC CCBT NCC
• Jagdeep Kaur, DMD
• Ashley Kelley-Shaidani, PT, DPT
• Douglas John Kennedy
• Kenneth a. Heisler, M.D.P.C.
• Christina Youngsim Kim-Gagnon, DMD
• Kelly A Kirkbride
• Marylouise Klimm, LICSW

• Mental Health Counselor in Falmouth, MA
• Providers in Falmouth, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.