Lisa Kelly

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1601 E 4TH Blvd.
Vancouver, WA 98661

Phone

(360) 397-8246

NPI assigned

Jan 16, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Barrett-Kelly Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Lifeline Connections

  • Substance Abuse Rehabilitation Facility
  • Vancouver, WA
  • NPI 1689892473
  NPD (past)

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1548734148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E 4TH BLVD.",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E 4TH BLVD.",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98661",
            "telephone_number": "360-397-8246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2924 Falk Rd",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986615604",
            "country_code": "US",
            "telephone_number": "360-397-8246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BARRETT-KELLY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Diane M Kelly, LMP
• Drew Monsen Kelly
• Duyane Lewis Kelly, LMP
• Elizabeth Ann Kelly, PT, DPT
• Joseph Kelly, DMD
• Madison Kelly
• Natalie Jade Kelly
• Nicole C Kelly, MD
• Rose Kelly, LICSW
• Tammy Jean Kelly, WA60557072

• Counselor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.