Kenneth D Kelly, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7756 Issued in SC

Practice address

2309 Devine St
Columbia, SC 29205-2422

Phone

(803) 250-1947

NPI assigned

Mar 31, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1285212159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 DEVINE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292052422",
            "telephone_number": "803-250-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 DEVINE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292052422",
            "telephone_number": "803-250-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KENNETH",
        "middle_name": "D",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2022-08-12",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "7756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO INSURANCE",
            "identifier": "3857",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Columbia",
            "affiliation": "N",
            "address_1": "2309 Devine St",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292052422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Columbia",
            "affiliation": "N",
            "endpointDescription": "TherapyNotes",
            "address_1": "2309 Devine St",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292052422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Columbia",
            "affiliation": "N",
            "endpointDescription": "a href='https://www.therapyportal.com/p/kenkelly/'Client Portal/a",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2309 Devine St",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292052422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charles Christopher Kelly, L.M.T
• Jalissa C Kelly, PMHNP
• Jennifer Amy Kelly
• Jocelyn Kelly
• Katherine Kelly
• Kimberly Stamps Kelly, RPH
• Laura Finklea Kelly, PHARMD
• Vanesia Davis Kelly, APRN
• Jessie Kemmler, PHARMD
• Edward McDonnell Kendall, M.D.

• Mental Health Counselor in Columbia, SC
• Providers in Columbia, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.