Mary Therese Kelleher, L.M.F.T.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166.000844 Issued in IL

Practice address

1800 Westlake Ave North
Suite 204
Seattle, WA 98109-2782

Phone

(206) 707-2718

NPI assigned

Sep 26, 2011

Last updated

May 27, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 25, 2024 through May 25, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1386927325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30906",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981130906",
            "telephone_number": "206-707-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 WESTLAKE AVE NORTH",
            "address_2": "SUITE 204",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092782",
            "telephone_number": "206-707-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "MARY",
        "middle_name": "THERESE",
        "name_prefix": "Ms.",
        "credential": "L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.000844",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1521",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keliottmd of Seattle LLC (BodyLogicMD of Seattle)
• Amy Arnold Keljo, ARNP
• Dale C Kellegrew, LMT
• Allison Nicole Kelleher, DMD
• J Daniel Kelleher, RT (R) (MR) ARRT
• Amber Keller
• Carolyn Sy Keller, MD
• Christopher J Keller, PHD
• Jennifer Jo Keller, LMT
• Jonathan Matthew Keller, M.D.

• Marriage & Family Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.

Verify at the official NPI Registry.