Lisa Kelledy, PHD, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1807 Issued in NC

Practice address

2309 W Cone Blvd
Suite 202
Greensboro, NC 27408-4044

Phone

(336) 317-7157

NPI assigned

Mar 26, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Shoals Family Therapy, P.C

  • Marriage & Family Therapist
  • Greensboro, NC
  • NPI 1801161401
  NPD (past)

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

{
    "created_epoch": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490486400000",
    "number": "1871024380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 W CONE BLVD",
            "address_2": "SUITE 202",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274084044",
            "telephone_number": "336-317-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 W CONE BLVD",
            "address_2": "SUITE 202",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274084044",
            "telephone_number": "336-317-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEDY",
        "first_name": "LISA",
        "credential": "PHD, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-26",
        "last_updated": "2017-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1807",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT2325",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason B Keith, MSW, LCSW
• Kayla N Keith, PA-C
• Preston Wylie Keith, DDS
• Ebony R Keitt, DC
• Victoria P Kellan, PT
• Rachael Teresa Kelleher, M.S.
• Carolyn Keller, PA-C
• Edweana Katrice Keller, FNP-C
• Hilary Keller
• Michaela Briana Keller

• Marriage & Family Therapist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Marriage & Family Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2017; 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.