Active NPI
McKerrin Kelly
- Marriage & Family Therapist
- Burbank, CA
National Provider Identifier
1285369983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 148098
- Practice address
- 1201 S Victory Blvd Ste 206
Burbank, CA 91502-2793 - Phone
- (747) 271-2701
- NPI assigned
- Jul 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 148098 | CA | Primary |
Addresses
Primary practice location
1201 S Victory Blvd Ste 206
Burbank, CA 91502-2793
Mailing address
115 N Canyon Blvd Apt a
Monrovia, CA 91016-2391
Phone (323) 788-0704
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 5, 2026 through Jan 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 148098 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721174400000",
"number": "1285369983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 N CANYON BLVD APT A",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910162391",
"telephone_number": "323-788-0704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 S VICTORY BLVD STE 206",
"city": "BURBANK",
"state": "CA",
"postal_code": "915022793",
"telephone_number": "747-271-2701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MCKERRIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-18",
"last_updated": "2024-07-17",
"certification_date": "2024-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "148098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.