Active NPI
Jennifer Kelly, PH.D.
- Clinical Psychologist
- Haddonfield, NJ
National Provider Identifier
1508991639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- SI003887
- Practice address
- 203 Kings Hwy E
Suite B
Haddonfield, NJ 08033-1901 - Phone
- (845) 428-7774
- Fax
- (856) 428-7774
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | SI003887 | NJ | Primary |
Addresses
Primary practice location
203 Kings Hwy E
Suite B
Haddonfield, NJ 08033-1901
Mailing address
203 Kings Hwy E
Suite B
Haddonfield, NJ 08033-1901
Phone (845) 428-7774
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SI003887 | NJ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508991639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 KINGS HWY E",
"address_2": "SUITE B",
"city": "HADDONFIELD",
"state": "NJ",
"postal_code": "080331901",
"telephone_number": "845-428-7774",
"fax_number": "856-428-7774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 KINGS HWY E",
"address_2": "SUITE B",
"city": "HADDONFIELD",
"state": "NJ",
"postal_code": "080331901",
"telephone_number": "845-428-7774",
"fax_number": "856-428-7774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "SI003887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haddonfield, NJ
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.