Jacqueline Kelly, PH.D.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1191 Issued in NC

Practice address

220 George W Liles Pkwy NW
Concord, NC 28027-6531

Phone

(704) 795-0423

NPI assigned

Aug 19, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1710293436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 SUMMERFORD CT NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280277712",
            "telephone_number": "704-467-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 GEORGE W LILES PKWY NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280276531",
            "telephone_number": "704-795-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent L Keipper, MD
• Keke'S Sunflower Garden Therapy and Counseling PLLC
• Douglas George Kelling Jr., MD
• Christine Elizabeth Kelly, M.S.
• Grace Ann Kelly, OTR/L
• Jane Ann Kelly, RN
• Latrece D Kelly
• Patrick Thomas Kelly, MD
• Tina Marie Kelly, FNP-C
• Christa Moore Kemp, LPC

• Marriage & Family Therapist in Concord, NC
• Providers in Concord, NC by specialty
• Marriage & Family Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; 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.