Betty A Kelahan, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

002990 Issued in GA

Practice address

621 North Ave NE Ste E100
Atlanta, GA 30308-2865

Phone

(404) 825-2875

Fax

(770) 507-5551

NPI assigned

Nov 28, 2006

Last updated

Jul 16, 2019By 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

Other names 1

• Annie Kelahan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 1, 2024 through Feb 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1871669093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 NORTH AVE NE STE E100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082865",
            "telephone_number": "404-825-2875",
            "fax_number": "770-507-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 NORTH AVE NE STE E100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082865",
            "telephone_number": "404-825-2875",
            "fax_number": "770-507-5551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3578 S Fulton Ave",
            "address_purpose": "LOCATION",
            "city": "Hapeville",
            "state": "GA",
            "postal_code": "303541756",
            "country_code": "US",
            "telephone_number": "404-669-3462",
            "fax_number": "404-669-3957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELAHAN",
        "first_name": "BETTY",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "002990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "KELAHAN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Audrey Keith
• Catherine Keith, NP
• Christopher Gatlin Keith, M.D.
• M Ouida Keith, LCSW
• Frazier Keitt, D.O.
• Karia Bryn Kelch-Oliver, PH.D.
• William J Keldahl, PA
• Katlyn Kelleher
• Meredith Page Kelleher, M.M.SC., PA-C
• Robert M Kelleher, M.D.

• Professional Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.

Verify at the official NPI Registry.