Judy Kelly

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF73071 Issued in CA

Practice address

224 West Graham Ave
Lake Elsinore, CA 92530

Phone

(951) 318-1351

NPI assigned

Aug 10, 2011

Last updated

Oct 15, 2024By the provider in NPPES

Sex

Female

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)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Corc Family Counseling Corporation

  • Marriage & Family Therapist
  • Lake Elsinore, CA
  • NPI 1538542352
  NPD (past)
• Corc Family Counseling Corporation

  • Marriage & Family Therapist
  • Lake Elsinore, CA
  • NPI 1972942191
  NPD (past)

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1861771677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5422",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928608014",
            "telephone_number": "213-247-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 WEST GRAHAM AVE",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "92530",
            "telephone_number": "951-318-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JUDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-10",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF73071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samson Kiarie Kangiri
• Katy Chou D D S Dental Corp
• Susan Marie Kell, PSY.D.
• Alyssa Michelle Kelley
• Dana Monroe Kelley
• Whiskey Kelsey
• Deanna Elizabeth Kennedy, MCPSS
• Jessica Kennedy
• Shalin Kent
• William Kerr, M.S. PA-C

• Marriage & Family Therapist in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Marriage & Family Therapist in California

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