Kelley Lynn Phelps
Individual provider Active NPI Marriage & Family Therapist · Murphys, CA
NPI 1194088807 · NPPES record last updated Oct 28, 2022
Key facts
- NPI
- 1194088807
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- LMFT98984 (CA)
- Practice address
- 788 Algiers St
Murphys, CA 95247-9583 - Phone
- (415) 758-0366
- NPI assigned
- Jun 18, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
- Opted out of Medicare
- Yes, effective Feb 29, 2024 through Mar 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77190 | CA | MD | Marriage & Family Therapist |
| LMFT98984 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Homeless Childrens Network | Marriage & Family Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 77190 | CA | |
| Marriage & Family Therapist | 106H00000X | LMFT98984 | CA | Yes |
Addresses
Primary practice location
788 Algiers St
Murphys, CA 95247-9583
Mailing address
788 Algiers St
Murphys, CA 95247-9583
Other providers in Murphys, CA
- Staci Lynn Nelson
- Timothy Jon O'Connor
- Jean L. Ogburn
- Sanaz Parsa
- Ann Elizabeth Pestalozzi
- Angela Alicia Richards
- Kyle Lars Richards
- Ilana Celeste Ryavec-Goranson
- Sanaz Parsa MD Inc
- David Jon Simons
All providers in Murphys, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.