Individual provider Active NPI

Suzanne P Kelley, LPC/MHSP, NCC

  • Professional Counselor
  • Chattanooga, TN
National Provider Identifier
1659569192
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2659 Issued in TN
Practice address
101 Jordan Dr
Chattanooga, TN 37421-6732
Phone
(423) 509-3829
NPI assigned
Oct 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2659 TN Primary

Addresses

Primary practice location

101 Jordan Dr
Chattanooga, TN 37421-6732

Mailing address

13574 Braxton LN
Birchwood, TN 37308-5089
Phone (423) 443-1312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1659569192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13574 BRAXTON LN",
            "city": "BIRCHWOOD",
            "state": "TN",
            "postal_code": "373085089",
            "telephone_number": "423-443-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 JORDAN DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374216732",
            "telephone_number": "423-509-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SUZANNE",
        "middle_name": "P",
        "credential": "LPC/MHSP, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-10",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "2659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.