Thomas M Kelley, PH.D

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6301001119 Issued in MI

Practice address

2888 E Long Lake Rd
Suite 170
Troy, MI 48085-3793

Phone

(248) 524-0050

Fax

(248) 524-0146

NPI assigned

Dec 22, 2005

Sex

Male

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1588640338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2888 E LONG LAKE RD",
            "address_2": "170",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853793",
            "telephone_number": "248-524-0050",
            "fax_number": "248-524-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 E LONG LAKE RD",
            "address_2": "SUITE 170",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853793",
            "telephone_number": "248-524-0050",
            "fax_number": "248-524-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6301001119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith W Kelley DDS PC
• Dani Lynn Keith
• Angela Kejbou, OTR/L
• Keith W. Kelley, D.D.S.
• Rebecca Mae Kelley, FNP
• Kelly Home Care Services, Inc.
• Kelly M. Giera, D.D.S., P.C.
• Charlotte M Kelly
• Kimberly Kelly, PH.D.
• Olivia Rose Kelly, TLLP

• Mental Health Counselor in Troy, MI
• Providers in Troy, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.