La Vaun Kelley, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1975 Issued in TN

Practice address

2515 Wilma Rudolph Blvd
Suite 107
Clarksville, TN 37040-5844

Phone

(931) 302-4519

NPI assigned

Jan 26, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Trinity Behavioral Health Services LLC

  • Community/Behavioral Health Agency
  • Clarksville, TN
  • NPI 1013317445
  NPD Authorized official

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1689970436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 FORREST COVE CT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405779",
            "telephone_number": "931-302-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 WILMA RUDOLPH BLVD",
            "address_2": "SUITE 107",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405844",
            "telephone_number": "931-302-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "LA VAUN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004981",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "1975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Keith
• Payton Nicolette Keith, LPC, MHSP
• Natalie Elaina Kela
• Amanda Keller, RBT
• Jessica Rene Kelley, LCSW
• Amanda Gail Kelly, MS, NCC
• Ashley Kelly, LMT
• Earl Lee Kelly, MD
• Gary Kelly, BC-HIS
• Kenneth Kelly, BC-HIS

• Professional Counselor in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; 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.