Laurence Merrill Kelly Sr., ED.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

NH-659 Issued in NH

Practice address

30 Canton St
Suite 13
Manchester, NH 03103-3524

Phone

(603) 625-1670

Fax

(603) 625-0335

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

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

Specialty

Clinical Psychologist

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457418451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CANTON ST",
            "address_2": "SUITE 13",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033524",
            "telephone_number": "603-625-1670",
            "fax_number": "603-625-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CANTON ST",
            "address_2": "SUITE 13",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033524",
            "telephone_number": "603-625-1670",
            "fax_number": "603-625-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LAURENCE",
        "middle_name": "MERRILL",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NH",
            "license": "NH-659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80008144",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel M Kelly-Martin
• Amy Kelly, LICSW,MLADC, LCS
• Anna Kathleen Kelly
• Dennis L Kelly, MD
• Kimberly C. Kelly, M.ED., BCBA
• Linda Kelly, LICSW
• Margaret T Kelly, CCC/SLP
• Amy S Kemp, M.S. CCC-SLP
• Kathleen Kendall
• Marquise Kendrick, BS

• Psychologist in Manchester, NH
• Providers in Manchester, NH by specialty
• Psychologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.