Active NPI
Erin Kelly
- Counselor
- Worcester, MA
National Provider Identifier
1457795999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 442899
- Practice address
- 548 Park Ave
Suite B
Worcester, MA 01603-2537 - Phone
- (774) 823-1500
- NPI assigned
- Apr 27, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 442899 | MA | Primary |
Addresses
Primary practice location
548 Park Ave
Suite B
Worcester, MA 01603-2537
Mailing address
94 Stoneleigh Rd
Holden, MA 01520
Phone (508) 210-0212
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 |
|---|---|---|---|
| 442899 | MA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367020800000",
"number": "1457795999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 STONELEIGH RD",
"city": "HOLDEN",
"state": "MA",
"postal_code": "01520",
"telephone_number": "508-210-0212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "548 PARK AVE",
"address_2": "SUITE B",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016032537",
"telephone_number": "774-823-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "ERIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-27",
"last_updated": "2013-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MA",
"license": "442899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.