Rachael Joy Kelly, LLPC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

6451023170 Issued in MI

Practice address

555 28TH St SE
Grand Rapids, MI 49548-1278

Phone

(616) 633-0231

NPI assigned

Sep 1, 2023

Last updated

Sep 1, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1558147991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 28TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495481278",
            "telephone_number": "616-633-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 28TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495481278",
            "telephone_number": "616-633-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "RACHAEL",
        "middle_name": "JOY",
        "credential": "LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6451023170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Jo Kelly, NP
• Brea Kelly
• Brendan Neubecker Kelly, LMSW
• Elizabeth Kelly
• Kendra Kelly
• Ryan Kelly, MD
• Sophie Grace Kelly
• Sydney E Kelly, CCC-SLP
• Teresa Gross Kelly, M.D
• John Philip Kelpin Jr., M.D.

• Counseling Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Counseling Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.