Individual provider Active NPI

Kelly O'Brien Clancey, M.S.

  • Marriage & Family Therapist
  • Sacramento, CA
National Provider Identifier
1104929173
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
50379 Issued in CA
Practice address
1743 Iverson Way
Sacramento, CA 95835-1238
Phone
(916) 214-0148
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 50379 CA Primary

Addresses

Primary practice location

1743 Iverson Way
Sacramento, CA 95835-1238

Mailing address

1743 Iverson Way
Sacramento, CA 95835-1238
Phone (916) 214-0148

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1104929173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 IVERSON WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351238",
            "telephone_number": "916-214-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 IVERSON WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351238",
            "telephone_number": "916-214-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANCEY",
        "first_name": "KELLY",
        "middle_name": "O'BRIEN",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "50379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.