Active NPI
Kelly Ann Clookey, LMHC
- Mental Health Counselor
- Syracuse, NY
National Provider Identifier
1467294280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 014796
- Practice address
- 2700 Bellevue Ave
Syracuse, NY 13219-3238 - Phone
- (315) 308-0736
- NPI assigned
- Jun 11, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 014796 | NY | Primary |
Addresses
Primary practice location
2700 Bellevue Ave
Syracuse, NY 13219-3238
Mailing address
25 South St Apt 89
Marcellus, NY 13108-1338
Phone (680) 214-7800
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 |
|---|---|---|---|
| 014796 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721779200000",
"number": "1467294280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 SOUTH ST APT 89",
"city": "MARCELLUS",
"state": "NY",
"postal_code": "131081338",
"telephone_number": "680-214-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 BELLEVUE AVE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132193238",
"telephone_number": "315-308-0736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLOOKEY",
"first_name": "KELLY",
"middle_name": "ANN",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-11",
"last_updated": "2024-07-24",
"certification_date": "2024-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "014796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.