Kelly Cheatham Counseling

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

65475 Issued in TX

Legal business name

KELLY CHEATHAM COUNSELING

Practice address

1500 Corporate Cir
Suite 4
Southlake, TX 76092-5953

Phone

(817) 228-1668

NPI assigned

Dec 12, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Lynn Cheatham, PHD

Title

President

Phone

(817) 228-1668

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1649714585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 HIDDEN MEADOW CT",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760928426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CORPORATE CIR",
            "address_2": "SUITE 4",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760925953",
            "telephone_number": "817-228-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY CHEATHAM COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2016-12-12",
        "status": "A",
        "authorized_official_last_name": "CHEATHAM",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-228-1668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "65475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Southlake, TX
• Providers in Southlake, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.