Audrey J Kelly, LMFT
Individual provider Active NPI Marriage & Family Therapist · Checotah, OK
NPI 1487930400 · NPPES record last updated Oct 24, 2011
Key facts
- NPI
- 1487930400
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 1026 (OK)
- Practice address
- RT 2
Checotah, OK 74426 - Phone
- (405) 640-4726
- NPI assigned
- Oct 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1026 | OK | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1026 | OK | Yes |
Addresses
Primary practice location
RT 2
Checotah, OK 74426
Mailing address
RT 2 Box 1292
Checotah, OK 74426
Phone (405) 640-4726
Other providers in Checotah, OK
- Kelly Hokit
- Hospice Advantage, LLC.
- Annette James
- Callie Mariah Kaiser
- Valerie Suzanne Kautz
- Kennedy Eyecare LLC
- Jamie Ann Lyons
- Kadee Marshall
- Joan Mayo
- Melanie Dianne McClellan
All providers in Checotah, OK · Marriage & Family Therapist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.