Kathleen Anne Kelley, MS, MFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MFC 21551 Issued in CA

Practice address

6117 Brockton Ave
Suite 102
Riverside, CA 92506-2232

Phone

(951) 686-0223

NPI assigned

Jan 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Master of Science

State licenses

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225186737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 HIGH DR",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926511730",
            "telephone_number": "949-715-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6117 BROCKTON AVE",
            "address_2": "SUITE 102",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062232",
            "telephone_number": "951-686-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "credential": "MS, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC 21551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Turner, M.D. a Professional Corporation
• Tariq A. Kelker, M.D.
• Deborah Ann Kelley, LCSW
• Felicia Priscilla Kelley, LCSW
• Grant McGregor Kelley, D.D.S.
• Hannah Elizabeth Kellogg
• Hannah M Kellogg
• Anthony Ringo Kelly Jr.
• Francina Kelly, MFT TRAINEE
• Jennifer Noel Kelly

• Mental Health Counselor in Riverside, CA
• Providers in Riverside, CA by specialty
• Mental Health Counselor in California

• 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.