SUSAN SCHACK KELLY (NPI# 1023658168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023658168 |
| Entity Type | Individual |
| Full Name | SUSAN SCHACK KELLY |
| Credential | PHD |
| Practice Address |
8609 Germantown Ave # 2f Philadelphia PA 19118-2863 |
| Practice Telephone | 6462652484 |
| Mailing Telephone | 6462652484 |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2020-01-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PS016698 | PA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992265003 | Susan Elizabeth Kelly | Nurse Practitioner | 239 Clifford Price Loop, Mooresburg, TN 37811-2337 | 2019-03-24 |
| 1770956617 | Susan Dale Kelly | Social Worker | 524 Brighton Ave, Spring Lake, NJ 07762-1561 | 2015-10-31 |
| 1356773097 | Susan J. Kelly | Social Worker | 31 Ownly Ave, West Haven, CT 06516-1245 | 2013-08-05 |
| 1992046007 | Susan Kelly | Nurse Practitioner | 3001 S Lincoln Ave Ste A, Steamboat Springs, CO 80487-1790 | 2013-03-14 |
| 1063708758 | Susan Fay Kelly | Social Worker | 100 So. Highland, Ossining, NY 10562 | 2011-06-22 |
| 1003029091 | Susan Eve Kelly | Occupational Therapist | 79 Blueberry La, Laconia, NH 03246 | 2007-05-07 |
| 1043386246 | Susan Kelly | Social Worker | 42 Wendell Avenue, Pittsfield, MA 01201 | 2006-11-28 |
| 1669566139 | Susan S Kelly | Physical Therapist | 1340 Lake Blvd., Davis, CA 95616 | 2006-10-02 |
| 1548200074 | Susan C Kelly | Dermatology | 7 Weaver Rd, North Kingstown, RI 02852-7135 | 2006-06-06 |
| 1679114581 | Susan M Kelly | Pediatrics | 900 S Caton Ave, Baltimore, MD 21229-5201 | 2019-10-01 |
| Street Address |
8609 GERMANTOWN AVE # 2F |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19118-2863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801380126 | Bridget Hirsch | Psychologist | 18 E Abington Avenue, Philadelphia, PA 19118 | 2018-06-20 |
| 1740719194 | Alyssa H Bloch | Speech-Language Pathologist | 8431 Germantown Avenue, Philadelphia, PA 19118 | 2017-06-08 |
| 1710344056 | Zachary Roberts | Physical Therapist | 19 West Highland Avenue, Philadelphia, PA 19118 | 2016-01-18 |
| 1164847810 | Judith Maxwell | Family Medicine | 415 West Mermaid Ln, Philadelphia, PA 19118 | 2014-03-04 |
| 1174963151 | Deborah Hope Cooper | Counselor | 22 E. Chestnut Hill Avenue, Samaritan Counseling Service, Philadelphia, PA 19118 | 2013-07-05 |
| 1730524349 | Breast-pump-rental.com | Durable Medical Equipment & Medical Supplies | 112 W Gravers Lane, Philadelphia, PA 19118 | 2013-05-09 |
| 1083964902 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 7700 Crittenden Ave., Philadelphia, PA 19118 | 2012-09-18 |
| 1215286679 | Jessica M Steedle | Speech-Language Pathologist | 102 East Mermaid Lane, Philadelphia, PA 19118 | 2012-08-31 |
| 1083960124 | Fahad Malik Akhtar | Family Medicine | 8815 Germantown Avenue, 5th Floor, Philadelphia, PA 19118 | 2012-07-26 |
| 1992026793 | Valerie Mikula Hughes | Dentist | 9 E. Highland Ave, Philadelphia, PA 19118 | 2010-06-15 |
| Find all providers in zip 19118 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851092 | Erica Marla Schulte | Psychologist | 3535 Market St Ste 3032, Philadelphia, PA 19104-3313 | 2020-11-02 |
| 1376159780 | Kristi Corcoran | Psychologist | 212 Catharine St Apt 5, Philadelphia, PA 19147-3398 | 2020-09-21 |
| 1033723317 | Casey Joan Zampella | Psychologist | 2716 South St Ofc 5322, Philadelphia, PA 19146-2305 | 2020-09-03 |
| 1265053755 | Shirley Brown | Psychologist | 210 W Rittenhouse Sq Ste 404, Philadelphia, PA 19103-5771 | 2020-05-06 |
| 1518507912 | Tamara Christine Hill | Psychologist | 245 Cherry St Apt 3f, Philadelphia, PA 19106-1991 | 2020-01-14 |
| 1265070379 | Jeannine Cicco Barker | Psychologist | 100 S Broad St Ste 915, Philadelphia, PA 19110-1016 | 2019-12-19 |
| 1003453952 | Bridget Smith | Psychologist | Stratton Hall, 3201 Chestnut St., 2nd Floor, Philadelphia, PA 19146 | 2019-12-10 |
| 1235790007 | Stephanie Manasse | Psychologist | 3201 Chestnut St, Philadelphia, PA 19104-3370 | 2019-06-24 |
| 1003376690 | Margaux Desjardins | Psychologist | 2200 Saint James Pl, Philadelphia, PA 19103-5502 | 2019-03-21 |
| 1124592407 | Joshua Rutherford | Psychologist | 1700 N Broad St Ste 2, Philadelphia, PA 19121-3429 | 2019-01-19 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19118 |
Please comment or provide details below to improve the information on SUSAN SCHACK KELLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.