Mary L Kelley

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1203 Issued in KY

Practice address

503 Centre View Blvd
Crestview Hills, KY 41017-3444

Phone

(859) 426-7800

Fax

(859) 426-7804

NPI assigned

May 26, 2006

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• MCB Behavioral Health, P.L.L.C.

  • Clinical Psychologist
  • Crestview Hills, KY
  • NPI 1336330422
  NPD (past)
• Neuroscience and Behavioral Health Associates

  • Clinical Neuropsychologist
  • Crestview Hills, KY
  • NPI 1346431434
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1114973369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17277",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410170277",
            "telephone_number": "859-426-7800",
            "fax_number": "859-426-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 CENTRE VIEW BLVD",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173444",
            "telephone_number": "859-426-7800",
            "fax_number": "859-426-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MARY",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "1203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kavya Kandarpa, PHD, BCBA-D
• Karl I. Lutes, D.M.D., P.L.L.C.
• Zehra Kazmi, MD
• Duane Leslie Keitel, M. D.
• Sarah F Keller, MD
• Danielle E Kelly, DPT
• Kristen D Kelly, OTR/L
• Kendall E Hansen MD PLC
• Colleen Marie Kennedy, PA-C
• Joseph Kitchen, MD

• Clinical Psychologist in Crestview Hills, KY
• Providers in Crestview Hills, KY by specialty
• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.