Individual provider Active NPI

Kelly Ann Clookey, LMHC

  • Mental Health Counselor
  • Syracuse, NY
National Provider Identifier
1467294280
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
014796 Issued in NY
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

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
014796NYMDClinical 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.

Verify at the official NPI Registry.