Kelly Earley, LISW
Individual provider Active NPI Mental Health Counselor · Belen, NM
NPI 1992825541 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992825541
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- I-06404 (NM)
- Practice address
- 1500 N Mesa Rd
Belen, NM 87002-8528 - Phone
- (505) 864-9113
- Fax
- (505) 861-3681
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-06404 | NM | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valencia Counseling Service Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | I-06404 | NM | Yes |
Addresses
Primary practice location
1500 N Mesa Rd
Belen, NM 87002-8528
Mailing address
PO Box 518
Los Lunas, NM 87031-0518
Phone (505) 865-3350
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 90424581 | Medicaid | NM |
Other providers in Belen, NM
- Rebecca Ann Dominguez
- Jenifer Lee Donnell
- Dr Daniel J Dieterichs, Optometrists, P.C.
- Dr. David Schneider'S Office
- Pamela E Duda
- Melissa Elkins-Lucero
- Lloyd Elliott
- Enchanted Smiles
- Anna Englund
- Jo Ann Farber
All providers in Belen, NM · Mental Health Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.