Mabel Kokonne Kelly, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

106499 Issued in TX

Practice address

1906 Dorsette CT
Sugar Land, TX 77498-6314

Phone

(832) 882-5797

NPI assigned

Dec 1, 2015

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

Other names 1

• Mabel Kokonne Henderson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fox Rehabilitation Services TX LLC

  • Physical Therapist
  • Allen, TX
  • NPI 1710582580

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1184098204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 DORSETTE CT",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774986314",
            "telephone_number": "832-882-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 DORSETTE CT",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774986314",
            "telephone_number": "832-882-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MABEL",
        "middle_name": "KOKONNE",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "106499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MABEL",
            "last_name": "HENDERSON",
            "middle_name": "KOKONNE",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John P. Kelley, MD
• Kellmarc Home Health Therapis
• Crystal Denise Kelly, MD
• Grace Nicole Kelly
• Hannah Elizabeth Kelly, PA-C
• Scott Andrew Kelly, D.C.
• Kenneth R Kemp Jr., MD
• Kenneth Duvall, PLLC
• Claire Kenney, DC
• Kensington Healthcare Services LLC

• Speech-Language Pathologist in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; 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.