Meghan C Kelley, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2049 Issued in OR

Practice address

3310 SE Division St
Portland, OR 97202-1457

Phone

(503) 729-4205

NPI assigned

Aug 15, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Innerwellness, LLC

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1366263212
  NPD Authorized official

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1376799890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021457",
            "telephone_number": "503-729-4205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021457",
            "telephone_number": "503-729-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MEGHAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Douglas Kelley, L.P.C.
• John Paul Kelley, QMHA
• Jolene Renee Kelley, LMT
• Kathryn Kelley
• Laurel Lenee Kelley, MD
• Melinda Kelley
• Meredith Kelley
• Peggy E Kelley, MD
• Steven Michael Kelley, M.A., CADC, QMHP
• Victoria Kelley

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.