J Kelly, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

01330000363 Issued in VA

Legal business name

J KELLY, LLC

Practice address

810 Housman CT
Virginia Beach, VA 23462-7010

Phone

(757) 450-3421

NPI assigned

Apr 26, 2016

Organization subpart

No

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

Authorized official

Name

Jessica Salome Kelly, MS, BCBA

Title

Behavior Analyst

Phone

(757) 450-3421

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461628800000",
    "number": "1427403534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 HOUSMAN CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234627010",
            "telephone_number": "757-450-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 HOUSMAN CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234627010",
            "telephone_number": "757-450-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J KELLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "SALOME",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "757-450-3421",
        "authorized_official_credential": "MS, BCBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "01330000363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.