ANDREA KELLIM (NPI# 1326320912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326320912 |
| Entity Type | Individual |
| Full Name | ANDREA KELLIM |
| Credential | LPC |
| Practice Address |
2200 E Matthews Ave Jonesboro AR 72401-4347 |
| Mailing Address |
2809 Forest Home Rd Jonesboro AR 72401-5320 |
| Practice Telephone | 8709721268 |
| Practice Fax Number | 8709340847 |
| Mailing Telephone | 8709721268 |
| Mailing Fax Number | 8709340847 |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2020-07-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
P0610058 | AR | Behavioral Health & Social Service Providers |
| Street Address |
2200 E MATTHEWS AVE |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-4347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932154945 | Life Strategies Counseling, Inc. | Clinic/Center | 2200 E Matthews Ave, Jonesboro, AR 72401-4347 | 2006-05-24 |
| 1215569298 | Juliane Veach | Case Manager/Care Coordinator | 2200 E Matthews Ave, Jonesboro, AR 72401-4347 | 2020-02-07 |
| 1104467513 | Nathan Walters | Case Manager/Care Coordinator | 2200 E Matthews Ave, Jonesboro, AR 72401-4347 | 2019-10-07 |
| 1245884915 | Maurice Ates | Social Worker | 2200 E Matthews Ave, Jonesboro, AR 72401-4347 | 2019-07-30 |
| 1982167722 | India Harris | Counselor | 2200 E Matthews Ave, Jonesboro, AR 72401-4347 | 2019-04-09 |
| 1699245480 | Madison Joy Hawkins | Case Manager/Care Coordinator | 2200 E Matthews Ave, Jonesboro, AR 72401-4347 | 2018-12-05 |
| 1346723699 | Chukwuemeka I Ota | Case Manager/Care Coordinator | 2200 E Matthews Ave, Jonesboro, AR 72401-4347 | 2018-09-12 |
| 1760968705 | Judith Melissa Halsell | Social Worker | 2200 E Matthews Ave, Jonesboro, AR 72401-4347 | 2018-07-12 |
| 1487156444 | Allison Marie Schulz | Social Worker | 2200 E Matthews Ave, Jonesboro, AR 72401-4347 | 2018-03-06 |
| 1902314735 | Landra Kay Jeffers | Case Manager/Care Coordinator | 2200 E Matthews Ave, Jonesboro, AR 72401-4347 | 2018-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184239360 | Haronepthia C Cameron | Counselor | 102 Lundy Ln, Jonesboro, GA 30238-2132 | 2020-09-14 |
| 1356993356 | New Behavioral Services LLC | Counselor | 216 N Mcdonough St, Jonesboro, GA 30236-3608 | 2019-07-10 |
| 1386107563 | Lashanda Robertson | Counselor | 124 S Main St Ste 2n, Jonesboro, GA 30236-3502 | 2019-04-13 |
| 1467987230 | Sharon Temple | Counselor | 10519 Cedar Knob, Jonesboro, GA 30238-8834 | 2017-04-28 |
| 1497207450 | Felita Bush | Counselor | 124 S Main St Ste 2g, Jonesboro, GA 30236-3502 | 2016-10-25 |
| 1164977583 | Dealva Kernodle | Counselor | 935 County Road 348, Jonesboro, AR 72401-0418 | 2016-08-16 |
| 1013372879 | Cassandra Walker | Counselor | 2617 Dancing Waters Dr, Jonesboro, GA 30236-4051 | 2015-12-22 |
| 1932512621 | Project Real Life Youth Occupational Training Corps, Inc. | Counselor | 6805 Tara Blvd, Jonesboro, GA 30236-1501 | 2014-06-10 |
| 1518384106 | Visions of Life Behavioral Health Services, Incorporated | Counselor | 754 Chapman Street, Jonesboro, GA 30238 | 2014-03-21 |
| 1922443993 | Ruth Wheller | Counselor | 1000 S Caraway Rd Ste 103, Jonesboro, AR 72401-4465 | 2013-05-06 |
| Find all providers in JONESBORO | ||||
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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.