Ophelia Kelly, L.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1820 Issued in MS

Practice address

2941 Terry Rd
Jackson, MS 39212-3073

Phone

(601) 373-0566

Fax

(601) 373-0566

NPI assigned

Nov 20, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ophelia Kelly Professional name

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": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1568706141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MEADOWVIEW CIR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565907",
            "telephone_number": "601-608-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2941 TERRY RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392123073",
            "telephone_number": "601-373-0566",
            "fax_number": "601-373-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "OPHELIA",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MS",
            "license": "W0803",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OPHELIA",
            "last_name": "KELLY",
            "credential": "L.S.W.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Isabella Kelly
• Jordan Christopher Kelly, DO
• Levella Kelly, PTA
• Mick Henry Kelly
• Morgan Kelly, MD
• Peggy L Kelly
• Penny Kelly, APRN
• Shenika Sharee Kelly
• Jeannie N Kelso, LCSW
• David Wayne Kelton, M.D.

• Professional Counselor in Jackson, MS
• Providers in Jackson, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; 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.