Active NPI
Michael S Kelly
- Marriage & Family Therapist
- Guilford, CT
National Provider Identifier
1396481719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 2313
- Practice address
- 34 York St Ste 4
Guilford, CT 06437-2473 - Phone
- (203) 453-2220
- NPI assigned
- May 9, 2022
- Sex
- Male
- 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 | 2313 | CT | Primary |
Addresses
Primary practice location
34 York St Ste 4
Guilford, CT 06437-2473
Mailing address
34 York St Ste 4
Guilford, CT 06437-2473
Phone (203) 453-2220
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2313 | CT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652054400000",
"number": "1396481719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 YORK ST STE 4",
"city": "GUILFORD",
"state": "CT",
"postal_code": "064372473",
"telephone_number": "203-453-2220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 YORK ST STE 4",
"city": "GUILFORD",
"state": "CT",
"postal_code": "064372473",
"telephone_number": "203-453-2220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MICHAEL",
"middle_name": "S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-09",
"last_updated": "2022-05-09",
"certification_date": "2022-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "2313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Guilford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.