The Kelley Clinic

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

THE KELLEY CLINIC

Practice address

1216 N Prospect Ave
Milwaukee, WI 53202-3014

Phone

(414) 271-9272

Fax

(414) 271-1299

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Jane Kelley, LCSWNPI 1689680860

Title

President

Phone

(414) 271-9272

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jane Ann Kelley, LCSW

  • Clinical Social Worker
  • Milwaukee, WI
  • NPI 1689680860
  NPD (past) Authorized official

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1265657704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 N PROSPECT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023014",
            "telephone_number": "414-271-9272",
            "fax_number": "414-271-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 N PROSPECT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023014",
            "telephone_number": "414-271-9272",
            "fax_number": "414-271-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KELLEY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-271-9272",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "000044264",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS PROVIDER",
            "identifier": "281076",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Milwaukee, WI
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

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