Alfred George Kellam, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301006080 Issued in MI

Practice address

202 E Washington St
Suite 510
Ann Arbor, MI 48104-2017

Phone

(734) 996-1944

NPI assigned

Dec 27, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2016 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1760547954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E WASHINGTON ST",
            "address_2": "SUITE 510",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042017",
            "telephone_number": "734-996-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E WASHINGTON ST",
            "address_2": "SUITE 510",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042017",
            "telephone_number": "734-996-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAM",
        "first_name": "ALFRED",
        "middle_name": "GEORGE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301006080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6301006080",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Kelch, DPT
• Erin Kelch, LLMSW
• Kelley L Kelch, LCSW, LMSW
• Sherwin Kelekar
• M Lane Kelemen, PH.D.
• Jesse Zane Kellar, M.D
• Joseph Keller, M.S., L.L.P.
• Kiana Keller, NP
• Lauri Lynn Keller, LMSW
• Alan Taylor Kelley, MD, MPH

• Clinical Psychologist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.