Morris Kellybrew, CADAC-CAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

C6461214 Issued in CA

Practice address

1230 N Marengo Ave
Pasadena, CA 91103-2217

Phone

(626) 797-1124

Fax

(626) 398-9674

NPI assigned

Feb 10, 2017

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: morriskellybrew-grandviewfoundation@lacsapc.netsmartdirect.net

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.

• Los Angeles County Department of Public Health

  • Public Health or Welfare Agency
  • Alhambra, CA
  • NPI 1700090834
  NPD

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1164960076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 N MARENGO AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911032217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 N MARENGO AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911032217",
            "telephone_number": "626-797-1124",
            "fax_number": "626-398-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLYBREW",
        "first_name": "MORRIS",
        "credential": "CADAC-CAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-10",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C6461214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C6461214",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryar Kelly
• Karissa Kelly
• Kevin M. Kelly, MEDICAL DOCTOR
• Kevonna Kelly
• Riley Kelly
• Trenton Kemp
• Jonathan Michael Kendall, LMFT
• Amanda N. Kendrick, PSYD
• Kailey Kennally
• Kenneth R. Sabbag MD PC

• Addiction (Substance Use Disorder) Counselor in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; 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.