MR. LARRY J KELLEY (NPI# 1255420428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255420428 |
| Entity Type | Individual |
| Full Name | MR. LARRY J KELLEY |
| Credential | M.S.W., L.C.S.W. |
| Practice Address |
6450 Blyth Rd Caledonia IL 61011-9644 |
| Practice Telephone | 8158853451 |
| Mailing Telephone | 8158853451 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073507448 | Larry Stephen Kelley | Registered Nurse | 150 Redwood Dr, Richmond, KY 40475-8617 | 2005-08-31 |
| 1598121576 | Larry Derbert Kelley | Case Manager/Care Coordinator | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334 | 2016-01-06 |
| 1346667987 | Larry Kelley | Health Educator | 6805 Ne Loop 820, Suite 408, Fort Worth, TX 76180-6687 | 2014-03-20 |
| 1679639033 | Larry Brice Kelley | Optometrist | 1805 Cooks Hill Rd, Centralia, WA 98531-9072 | 2006-12-29 |
| Street Address |
6450 BLYTH RD |
| City | CALEDONIA |
| State | IL |
| Zip Code | 61011-9644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467099259 | Scott Laubenstein | Behavior Technician | 5039 Vail Dr, Caledonia, IL 61011-9005 | 2019-11-29 |
| 1760807937 | Kaitlin Adams | Specialist/Technologist | 7580 Bridlewood Rd, Caledonia, IL 61011-9013 | 2014-02-25 |
| 1134240989 | Ila Mae Minnick | Registered Nurse | 7604 Bridlewood Rd, Caledonia, IL 61011-9013 | 2007-04-02 |
| 1609395482 | Emily Nicole Cork | Speech-Language Pathologist | 2311 Randolph St, Caledonia, IL 61011-9321 | 2017-09-13 |
| 1508372871 | Lisa Dejong | Psychologist | 2311 Randolph St, Caledonia, IL 61011-9321 | 2017-12-21 |
| 1023426319 | Rebecca Murphy | Developmental Therapist | 5460 Winners Cir, Caledonia, IL 61011-9694 | 2014-07-30 |
| 1306215835 | Grant Panzella | Specialist/Technologist | 11917 Lerwick Rd, Caledonia, IL 61011-9781 | 2015-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255930962 | Benjamin Foddrill | Specialist/Technologist | 7380 Clearview Dr, Caledonia, MI 49316-9309 | 2020-10-22 |
| 1972115251 | Transformative Counseling Services | Psychologist | 8965 Lenter Dr Se, Caledonia, MI 49316-7793 | 2020-08-19 |
| 1457960080 | Barbara Stacy | Speech-Language Pathologist | 7010 Glen Creek Dr Se, Caledonia, MI 49316-7903 | 2020-07-29 |
| 1881203990 | West Michigan Dental Professionals | Clinic/Center | 6477 Cherry Meadow Dr Se Ste 1, Caledonia, MI 49316-7351 | 2020-07-24 |
| 1881214518 | Advanced Telepractice Enterprises, LLC | Speech-Language Pathologist | 5104 76th St Se, Caledonia, MI 49316-7913 | 2020-04-22 |
| 1083249155 | Goggin Boarding Home, LLC | Custodial Care Facility | 620 Country Road 40, Caledonia, MO 63631 | 2020-03-09 |
| 1477185478 | Andrew Tyler Schohl | Behavior Technician | 6875 Kalamazoo Ave Se, Caledonia, MI 49316-8950 | 2020-02-07 |
| 1467099259 | Scott Laubenstein | Behavior Technician | 5039 Vail Dr, Caledonia, IL 61011-9005 | 2019-11-29 |
| 1851941686 | Gloria Evelan Schroeder | Technician | 117 N 1st Street, Caledonia, MN 55921 | 2019-09-13 |
| 1134783905 | Pam N Taylor | Home Health Aide | 537 Round Lake Dr, Caledonia, MI 49316-9225 | 2019-04-27 |
| Find all providers in CALEDONIA | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366914897 | Mary Sue Vander Stel | Social Worker | 2045 76th St Se, Caledonia, MI 49316-9125 | 2018-12-21 |
| 1457638850 | Laura Myers | Social Worker | 6505 Cherry Meadow Dr Se, Caledonia, MI 49316-9484 | 2011-11-14 |
| 1427372051 | Elana Pagano Shaffer | Social Worker | 2926 W Main St, 4, Caledonia, NY 14423-9585 | 2010-03-25 |
| 1891916045 | Phyllis M Schadler | Social Worker | 9960 Rolling Hills Dr Se, Caledonia, MI 49302 | 2007-05-02 |
| 1427692078 | Candace Yeager | Social Worker | 9090 S Rodgers Ct Se Ste D, Caledonia, MI 49316-8052 | 2019-11-06 |
| 1790153856 | Kimberly Bartz Pllc | Social Worker | 9809 Cherry Valley Ave Se, Caledonia, MI 49316-9592 | 2015-09-07 |
| 1003282146 | Kimberly Bartz | Social Worker | 9809 Cherry Valley Ave Se, Caledonia, MI 49316-9592 | 2015-08-12 |
| 1952798969 | Lrea Therapy LLC | Social Worker | 9809 Cherry Valley Ave Se, Caledonia, MI 49316-9592 | 2015-04-17 |
| 1255612248 | Grace Louise Fryling | Social Worker | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2011-09-02 |
| 1992984058 | Michael Jack Reiffer | Social Worker | 9090 S Rodgers Ct Se, Suite D, Caledonia, MI 49316-8052 | 2007-10-25 |
| Find all providers in CALEDONIA | ||||
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| 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.