Shanae Kelley

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34009041A Issued in IN

Practice address

3505 Washington Blvd
Indianapolis, IN 46205-3718

Phone

(317) 920-5900

NPI assigned

Aug 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Compassionate Path Counseling Services

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1568311520
  NPD Authorized official

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687564800000",
    "number": "1174715973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11186 KNIGHTSBRIDGE LN",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379299",
            "telephone_number": "317-457-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 WASHINGTON BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053718",
            "telephone_number": "317-920-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14540 Prairie Lakes Blvd N",
            "address_purpose": "LOCATION",
            "city": "Noblesville",
            "state": "IN",
            "postal_code": "460604366",
            "country_code": "US",
            "telephone_number": "317-565-4642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SHANAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2023-06-24",
        "certification_date": "2023-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009041A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Gaylor Kelley, DDS
• Paige Kelley
• Patrick E Kelley, MD
• Ronda Kelley
• Ryan John Kelley
• Shelly Kelley, LCAC
• Stephanie Kelley
• Susan Kelley, LCSW, LCAC
• William E Kelley, MD
• Jenna Kellough

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2023; 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.