Eliseha Ennee Kelly, LMP

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA 60253578 Issued in WA

Practice address

1812 E Madison St
Seattle, WA 98122-2843

Phone

(206) 850-6428

NPI assigned

Mar 20, 2012

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

State licenses

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1255606448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 S FRONTENAC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981183627",
            "telephone_number": "206-850-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 E MADISON ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222843",
            "telephone_number": "206-850-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ELISEHA",
        "middle_name": "ENNEE",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA 60253578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela F Kelly, LMHC GMHS
• Corinne Dee Kelly, L.M.P.
• Cory Michael Kelly
• D. Patrick Kelly, M.D.
• Debra Eugenia Kelly, CPC, AARC
• Elizabeth Kelly, BCBA
• Emily Kelly
• Erin Kelly
• Janet Lynn Kelly, PHARM.D
• Jennifer D. Kelly, PSY.D.

• Specialist in Seattle, WA
• Providers in Seattle, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.