Active NPI
Anni Kelley-Day, LPCC
- Counselor
- San Mateo, CA
National Provider Identifier
1811132533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1720 S Amphlett Blvd
Ste 104
San Mateo, CA 94402-2702 - Phone
- (650) 578-8691
- NPI assigned
- Dec 9, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1720 S Amphlett Blvd
Ste 104
San Mateo, CA 94402-2702
Mailing address
407 Sherman Ave
Ste C
Palo Alto, CA 94306-1873
Phone (650) 461-9026
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 8, 2024 through Jul 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 269 | CA | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palo Alto Therapy a Licensed Clinical Social Worker Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Palo Alto, CA
- NPI 1457754962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479772800000",
"number": "1811132533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 SHERMAN AVE",
"address_2": "STE C",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943061873",
"telephone_number": "650-461-9026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 S AMPHLETT BLVD",
"address_2": "STE 104",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944022702",
"telephone_number": "650-578-8691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY-DAY",
"first_name": "ANNI",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-09",
"last_updated": "2016-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.