Individual provider Active NPI

Lauren K Kelly, MA, LMFT

  • Marriage & Family Therapist
  • Suwanee, GA
National Provider Identifier
1245480326
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT001099 Issued in GA
Practice address
1000 Peachtree Industrial Blvd
Suite 6-284
Suwanee, GA 30024-6737
Phone
(770) 530-1821
NPI assigned
Sep 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT001099 GA Primary

Addresses

Primary practice location

1000 Peachtree Industrial Blvd
Suite 6-284
Suwanee, GA 30024-6737

Mailing address

1000 Peachtree Industrial Blvd
Suite 6-284
Suwanee, GA 30024-6737
Phone (770) 530-1821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFT001099GAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1245480326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "SUITE 6-284",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246737",
            "telephone_number": "770-530-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "SUITE 6-284",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246737",
            "telephone_number": "770-530-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LAUREN",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.