Kaelyn Marie Licensed Professional Clinical Counselor Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

KAELYN MARIE LICENSED PROFESSIONAL CLINICAL COUNSELOR INC

Practice address

3033 Fifth Ave Ste 230
San Diego, CA 92103-5873

Phone

(323) 628-8452

NPI assigned

Feb 1, 2025

Organization subpart

No

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

Authorized official

Name

Kaelyn Kennedy, LPCC

Title

Ceo

Phone

(509) 951-2783

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1738368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1437963485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 FIFTH AVE STE 230",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035873",
            "telephone_number": "509-951-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 FIFTH AVE STE 230",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035873",
            "telephone_number": "323-628-8452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAELYN MARIE LICENSED PROFESSIONAL CLINICAL COUNSELOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-01",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "KAELYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-951-2783",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maggie M Kading, RDH
• Michelle Kadlac
• Richard Preston Kadota, M.D.
• Melissa Bess Kae, PSYD
• David Maurer Kaegi, M.D.
• Edward Preston Kaenel, D.D.S.
• Valerie Elizabeth Kaenel, D.D.S.
• Aya Wamidh Kafaji
• Zaphanlene Kaffey
• Aarya Kafi, M.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.