Thomas John Kelly, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LC3444 Issued in ME

Practice address

1 Delta Dr
Westbrook, ME 04092-4745

Phone

(207) 853-7227

Fax

(207) 856-2112

NPI assigned

Jul 27, 2018

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cap Quality Care, Inc.

  • Methadone Clinic
  • Westbrook, ME
  • NPI 1184762247
  NPD (past)

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1477030823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BROOKSIDE DR",
            "city": "CUMBERLAND",
            "state": "ME",
            "postal_code": "040214057",
            "telephone_number": "207-357-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DELTA DR",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040924745",
            "telephone_number": "207-853-7227",
            "fax_number": "207-856-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-27",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC3444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207LA0401X",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin D Kapelson, LADC
• Brenna S Keefe, M.S. OTR/L
• Abigail Keenan, DO
• Arlene M. Kellman, D.O.
• Sophia Kelly, BCBA
• Catherine Ann Kemps, LCSW
• Sherry Kessler
• Lecea A Ketzler, DO
• Jamie Kilton, MOTR/L
• Marc Daniel Kimball, M.D.

• Addiction (Substance Use Disorder) Counselor in Westbrook, ME
• Providers in Westbrook, ME by specialty
• Addiction (Substance Use Disorder) Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; 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.