Georgia Blaze Kelley

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1330 Ala Moana Blvd Ste 1
Honolulu, HI 96814-4262

Phone

(808) 585-1424

NPI assigned

Apr 15, 2024

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hawaii Behavioral Health, LLC

  • Marriage & Family Therapist
  • Honolulu, HI
  • NPI 1699430777
  NPD
• Hawaii Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Honolulu, HI
  • NPI 1881742104
  NPD

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1790539989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 LUNALILO HOME RD APT 118",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968251707",
            "telephone_number": "310-920-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ALA MOANA BLVD STE 1",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144262",
            "telephone_number": "808-585-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "GEORGIA",
        "middle_name": "BLAZE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine L Keller, PT, DPT
• Josh Keller, MPAS
• Mara Keller
• Jacqueline Kelley-Uyeoka
• Charles Roy Kelley, M.D.
• Nyiah Kelley
• Kellie Kurasaki, MD, LLC
• Kellie Wo MD LLC
• Bart M Kellner, PT, CMPT, CSCS
• Gina R. Kellner, M.D.

• Behavior Technician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Behavior Technician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.