Kelley Clinic LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

598 Issued in WI

Legal business name

KELLEY CLINIC LLC

Practice address

1216 N Prospect Ave
Milwaukee, WI 53202-3061

Phone

(414) 536-8604

Fax

(414) 536-8605

NPI assigned

Jan 9, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Jane A Kelley, LCSW

Title

Owner

Phone

(414) 271-9272

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231459200000",
    "number": "1881831014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 N PROSPECT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023061",
            "telephone_number": "414-536-8604",
            "fax_number": "414-536-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 N PROSPECT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023061",
            "telephone_number": "414-536-8604",
            "fax_number": "414-536-8605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLEY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-09",
        "last_updated": "2009-01-09",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-271-9272",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Elaine Keller, CADCIII
• Joshua Keller
• Katelyn Rose Keller
• Mary Margaret Keller, APNP
• Tracy C Keller, LPC
• Shannon Rae Kelley-Poulos, PSYD
• Brian Kelley
• Briana Kelley, CNA
• Elizabeth Caroline Kelley, MS/CCC-SLP
• Jane Ann Kelley, LCSW

• Clinical Social Worker in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; 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.