Kelly Ketcham, MA, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37AC00761700 Issued in NJ

Practice address

516 Bay Ave Ste 3
Point Pleasant Beach, NJ 08742-2554

Phone

(848) 235-9290

NPI assigned

Jan 8, 2024

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)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1952171175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CHESTNUT ST",
            "city": "BEACHWOOD",
            "state": "NJ",
            "postal_code": "087224535",
            "telephone_number": "732-600-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 BAY AVE STE 3",
            "city": "POINT PLEASANT BEACH",
            "state": "NJ",
            "postal_code": "087422554",
            "telephone_number": "848-235-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHAM",
        "first_name": "KELLY",
        "credential": "MA, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00761700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donn Matthew Hoosack, PA-C
• Hoosier Care Inc (Claremont Center)
• Kevin Vincent Hyland, ATC
• Thomas H Jordan Jr., LCADC - NJ
• Casey Kaighn, LPC
• Roosey Khawly, MD
• Anthony Kilcoyne
• Dimitrios Lambrou, DC
• Catherine H Laplante, IBCLC
• Joanna Liotta

• Mental Health Counselor in Point Pleasant Beach, NJ
• Providers in Point Pleasant Beach, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.