Active NPI
Laura W. Kelly, PSY.D.
- Clinical Psychologist
- Tuskegee, AL
National Provider Identifier
1316028418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS1046
- Practice address
- 2400 Hospital Rd
Tuskegee, AL 36083-5001 - Phone
- (334) 727-0550
- NPI assigned
- Oct 17, 2006
- Last updated
- Sep 20, 2010
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS1046 | ME | Primary |
Addresses
Primary practice location
2400 Hospital Rd
Tuskegee, AL 36083-5001
Mailing address
2400 Hospital Rd
Tuskegee, AL 36083-5001
Phone (334) 300-2785
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS1046 | ME | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284940800000",
"number": "1316028418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 HOSPITAL RD",
"city": "TUSKEGEE",
"state": "AL",
"postal_code": "360835001",
"telephone_number": "334-300-2785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 HOSPITAL RD",
"city": "TUSKEGEE",
"state": "AL",
"postal_code": "360835001",
"telephone_number": "334-727-0550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "LAURA",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2010-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ME",
"license": "PS1046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuskegee, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.