Kelley Johnson

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

KELLEY JOHNSON

Practice address

4455 S Pecos Rd Ste C
Las Vegas, NV 89121-5029

Phone

(702) 350-1430

NPI assigned

Jun 11, 2019

Organization subpart

No

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

Authorized official

Name

Kelley JohnsonNPI 1336320555

Title

Owner

Phone

(702) 810-8268

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Connecting The Dots Therapy Services LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelley Nicole Johnson

  • Clinical Social Worker
  • Las Vegas, NV
  • NPI 1336320555
  NPD Authorized official

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563408000000",
    "number": "1669031852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3928 BAGUA CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 S PECOS RD STE C",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215029",
            "telephone_number": "702-350-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLEY JOHNSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-07-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-810-8268"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "NV201911111296",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connecting The Dots Therapy Services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nathan Urbani Keller
• Phanesha Keller
• Shellie Jo Keller, CPC, CADC-I
• Stuart Keller
• Valerie Kelley Caesar
• Michael Patrick Kelley-Babbitt
• Anna Kelley
• Ashley V Kelley, M.D.
• Brittany Kelley, RN
• Christina Nicole Kelley

• Adult Mental Health Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Adult Mental Health Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.