Carol P Gray Kelley, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC15858ME Issued in ME

Practice address

836 Main Street
Westbrook, ME 04092

Phone

(207) 712-1971

NPI assigned

Sep 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Carol Gray Kennedy Former name

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1275638769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PRIDE STREET",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "04092",
            "telephone_number": "207-712-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 MAIN STREET",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "04092",
            "telephone_number": "207-712-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY KELLEY",
        "first_name": "CAROL",
        "middle_name": "P",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "CC1858",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC15858ME",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "GRAY KENNEDY",
            "credential": "LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Westbrook, ME
• Providers in Westbrook, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.