Susan Dorothea Kelley, PH.D.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH1135 Issued in FL

Practice address

5201 W Kennedy Blvd
Ste 615
Tampa, FL 33609-1845

Phone

(813) 974-0971

NPI assigned

Feb 22, 2007

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)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225163058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 272749",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336882749",
            "telephone_number": "813-969-3137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 W KENNEDY BLVD",
            "address_2": "STE 615",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091845",
            "telephone_number": "813-974-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SUSAN",
        "middle_name": "DOROTHEA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH1135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jospeh William Kelley
• Karohn T Kelley
• Kimberlyn Nanetta Kelley, OTD, OTR/L
• Kristina Kelley, CCC-SLP
• Meghan E. Kelley
• Tammy Rena Kelley, LMT
• Kelli Care Homemaker and Companion Services
• George Kellner, MD
• Christine Claire Kellogg, P.T., D.O.M.
• Erica Abanil Kellogg, APRN

• Mental Health Counselor in Tampa, FL
• Providers in Tampa, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.