Barbara Kelly, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

002178 Issued in CT

Practice address

475 Clinton Ave
Bridgeport, CT 06605-1700

Phone

(203) 368-5515

Fax

(203) 368-9167

NPI assigned

Apr 20, 2012

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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Barbara Kelly, LPC

  • Professional Counselor
  • Bethel, CT
  • NPI 1861800625
  NPD (past)

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1114284601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 CLINTON AVENUE",
            "address_2": "FSW, INC",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051700",
            "telephone_number": "203-368-5515",
            "fax_number": "203-368-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 CLINTON AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051700",
            "telephone_number": "203-368-5515",
            "fax_number": "203-368-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BARBARA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-20",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004069985",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Keenan
• Ryan Keenan, PMHNP
• Lisa Maria Kegel, N.P.
• Andrew John Kehrer, DO
• Jill S Keller, APRN
• Blaze Kelly, DO
• Lauren Alexis Kelly, PA-C
• Sarena Kelly, MSN, FNP-BC
• Sean R. Kelly, MD
• Natalia Kembaren, BCBA

• Professional Counselor in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.