Ron Anton Kelly, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

04369 Issued in MD

Practice address

30 Greenway St NW
Suite 5
Glen Burnie, MD 21061-3557

Phone

(410) 760-9079

NPI assigned

Nov 15, 2007

Sex

Male

Sole proprietor

Yes

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)

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.

• Greater Baltimore Counseling Center, LLC

  • Clinical Psychologist
  • Glen Burnie, MD
  • NPI 1376616938
  NPD (past)
• Oasis the Mental Health Center, LLC

  • Psychiatry Physician
  • Glen Burnie, MD
  • NPI 1174606057
  NPD (past)

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1750562013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10227 DOTTYS WAY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443886",
            "telephone_number": "301-233-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 GREENWAY ST NW",
            "address_2": "SUITE 5",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613557",
            "telephone_number": "410-760-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "RON",
        "middle_name": "ANTON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Catherine Kellenberger, LCSW-C
• Delayna Keller, RN
• Rachel E Keller, LSW
• Rebecca Jane Kelley, DNP, CRNP, A-GNP-C
• Tamara Nicole Kelley, M.S., LCADC
• Kelton Medical, LLC
• Kena Rae LLC
• Kenah One Health Care Services, LLC
• Kenah One Health Care Services, LLC
• Kenah One Health Care Services, LLC

• Clinical Psychologist in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.