Cheryl Kelly, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

404727 Issued in NY

Practice address

6 Horseshoe CT
New City, NY 10956-6607

Phone

(917) 886-7422

NPI assigned

Apr 21, 2023

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1912694605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HORSESHOE CT",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109566607",
            "telephone_number": "917-886-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HORSESHOE CT",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109566607",
            "telephone_number": "917-886-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CHERYL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kavanah Medical PLLC
• Gabrielle Kawalick
• Ok Jean Keh, L. AC.
• Marissa Kellman, LCSW
• Kelly Mulvihill, Ms, PT, PC
• Christopher Kelly
• Debra A Kelly, LPN
• Irene Kelly, MD
• Jacqueline Rose Kelly
• Jane Ellen Kelman, MD

• Psychiatric/Mental Health Clinical Nurse Specialist in New City, NY
• Providers in New City, NY by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.