Jennifer Kelly, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

05600 Issued in MD

Practice address

479 Jumpers Hole Rd
Suite 106
Severna Park, MD 21146-1600

Phone

(410) 647-8840

NPI assigned

Apr 16, 2015

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)

Enrolled

Credentials

Doctor of Philosophy

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.

• Kahn & Cooper- Kahn Chartered

  • Psychologist
  • Severna Park, MD
  • NPI 1659416899
  NPD (past)

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1861889826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 N MONTFORD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212241050",
            "telephone_number": "914-879-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 JUMPERS HOLE RD",
            "address_2": "SUITE 106",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211461600",
            "telephone_number": "410-647-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JENNIFER",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-16",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "05600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Jay Katz, MD
• Antoinette Marie Kavades, LMSW
• Laura Keimig
• Megan Kelley
• Vanessa Kellner
• Lisa Catherine Kelly
• Kenilworth Therapeutic Services, Inc.
• Kennard Chiropractic & Physical Therapy
• Ross Yeager Kennard, D.C.
• Colleen Shea Kennedy, LMSW, CAC-AD

• Psychologist in Severna Park, MD
• Providers in Severna Park, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.