Kimberly Kelleher

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC14859 Issued in MD

Practice address

9 Newburg Ave Ste 102
Catonsville, MD 21228-5157

Phone

(443) 840-7862

NPI assigned

Jul 28, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Aug 3, 2024 through Aug 3, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Grounded Living Therapy, LLC

  • Mental Health Counselor
  • Oakland, MD
  • NPI 1609619147

  Professional

  NPD Authorized official
• Stride Forward Counseling LLC

  • Adult Mental Health Clinic/Center
  • Catonsville, MD
  • NPI 1881209815
  NPD
• Clear Mind Marriage and Family Counseling, Inc.

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1548830391
  NPD (past)
• Stepping Stone of San Diego

  • Substance Abuse Rehabilitation Facility
  • San Diego, CA
  • NPI 1750408464
  NPD (past)

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1629687306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38535",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212318535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 NEWBURG AVE STE 102",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285157",
            "telephone_number": "443-840-7862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3655 Nobel Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921221005",
            "country_code": "US",
            "telephone_number": "858-750-7379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "15654",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC14859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Norris Therapy LLC
• Katzen Medical Associates, PC
• Tahoora Kawaja, M.D.
• Jahneen N Keatz, LMSW
• Achamma Keerikkattil
• Kyle Kellermeyer, LGPC
• Rachel Kelly
• Victoria Francesca Kennedy-Adkins, PSY.D.
• Amanda M Kern, LCSW-C
• Kathleen Kern, LCSW-C

• Professional Counselor in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.