Active NPI
Melissa Ann Kelly, LMFT
- Marriage & Family Therapist
- Rocky Hill, CT
National Provider Identifier
1487708384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 001163
- Practice address
- 21 New Britain Avenue
Suite 215
Rocky Hill, CT 06067 - Phone
- (860) 529-8977
- NPI assigned
- Jan 22, 2007
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 001163 | CT | Primary |
Addresses
Primary practice location
21 New Britain Avenue
Suite 215
Rocky Hill, CT 06067
Mailing address
68 Parish Drive
Kensington, CT 06037
Phone (860) 828-0110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11668007 | Other | CT | CAQH PROVIDER NUMBER |
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 |
|---|---|---|---|
| 001163 | CT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487708384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 PARISH DRIVE",
"city": "KENSINGTON",
"state": "CT",
"postal_code": "06037",
"telephone_number": "860-828-0110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 NEW BRITAIN AVENUE",
"address_2": "SUITE 215",
"city": "ROCKY HILL",
"state": "CT",
"postal_code": "06067",
"telephone_number": "860-529-8977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MELISSA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "001163",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH PROVIDER NUMBER",
"identifier": "11668007",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rocky Hill, CT
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.