ALYSSE LYNETTE KELLY (NPI# 1386284685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386284685 |
| Entity Type | Individual |
| Full Name | ALYSSE LYNETTE KELLY |
| Credential | CRM |
| Practice Address |
149 S Main St Phoenix OR 97535-6631 |
| Mailing Address |
Po Box 1257 Phoenix OR 97535-1257 |
| Practice Telephone | 5415354133 |
| Mailing Telephone | 5415354133 |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2020-01-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649788522 | Alysse Brianne Kelly | Nurse Anesthetist, Certified Registered | 200 Lothrop St, Pittsburgh, PA 15213-2536 | 2018-01-13 |
| Street Address |
149 S MAIN ST |
| City | PHOENIX |
| State | OR |
| Zip Code | 97535-6631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871110023 | Zhawen Wahpepah | Counselor | 149 S Main St, Phoenix, OR 97535-6631 | 2020-07-02 |
| 1871110304 | Melissa Chapman | Counselor | 149 S Main St, Phoenix, OR 97535-6631 | 2020-06-30 |
| 1679190565 | Sarah Grubbs | Counselor | 149 S Main St, Phoenix, OR 97535-6631 | 2020-06-26 |
| 1881211696 | Mario Guzman | Counselor | 149 S Main St, Phoenix, OR 97535-6631 | 2020-06-26 |
| 1144847039 | Trinity Okzana Leonis | Counselor | 149 S Main St, Phoenix, OR 97535-6631 | 2020-06-26 |
| 1558905000 | Dirk William Stafford | Counselor | 149 S Main St, Phoenix, OR 97535-6631 | 2019-10-28 |
| 1851934533 | Holly Ivie | Counselor | 149 S Main St, Phoenix, OR 97535-6631 | 2019-10-24 |
| 1275176398 | Emily E Hinman | Counselor | 149 S Main St, Phoenix, OR 97535-6631 | 2019-10-21 |
| 1225687668 | Mary Kate Regan | Counselor | 149 S Main St, Phoenix, OR 97535-6631 | 2019-09-09 |
| 1053967570 | Shelby Bryne Smith | Counselor | 149 S Main St, Phoenix, OR 97535-6631 | 2019-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417318577 | Brent M Gordon | Counselor | 5505 S Pacific Hwy, Phoenix, OR 97535 | 2016-03-16 |
| 1740649821 | Elizabeth Van Driel | Counselor | 149 N Main Street, Phoenix, OR 97535 | 2016-02-17 |
| 1740611458 | William Allen Haden Jr. | Social Worker | 106 N. Rose Street, Phoenix, OR 97535 | 2013-12-05 |
| 1528396470 | Sarah Bly | Midwife, Lay | 509 5th St., Phoenix, OR 97535 | 2009-12-03 |
| 1992961239 | Stephen J Brummett | Counselor | 482 Elm St, Phoenix, OR 97535 | 2008-08-06 |
| 1568680577 | Christine Carolyn Robinson | Chiropractor | 721 N. Main St., Space A, Phoenix, OR 97535 | 2007-04-23 |
| 1982729539 | Daniel Jansen | Counselor | 215 N Rose St, Phoenix, OR 97535 | 2007-03-20 |
| 1770196016 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 106 N. Rose Street, Phoenix, OR 97535 | 2020-08-26 |
| 1760972160 | Jennifer L Burke | Counselor | 149 N Main Street, Phoenix, OR 97535 | 2018-05-11 |
| 1124552872 | Desiree Thompson | Counselor | 149 N Main St, Phoenix, OR 97535 | 2017-04-19 |
| Find all providers in zip 97535 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518465012 | Cesar Alejandro Mercado | Peer Specialist | 137 Sharon Dr, Phoenix, OR 97535-5713 | 2018-01-30 |
| 1235737156 | Timothy Chakos-kender | Peer Specialist | 4343 N 16th St, Phoenix, AZ 85016-5338 | 2020-10-13 |
| 1518565696 | Aaron R Fry | Peer Specialist | 4343 N 16th St, Phoenix, AZ 85016-5338 | 2020-10-12 |
| 1851945166 | Jesse Anthony Ruelas | Peer Specialist | 1500 E Thomas Rd Ste 106, Phoenix, AZ 85014-5748 | 2019-07-25 |
| 1609273382 | Shellye D Byers | Peer Specialist | 9428 W Highland Ave, Phoenix, AZ 85037-1015 | 2014-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1578162145 | Kenneth Branson | Peer Specialist | 389 Sw Scalehouse Ct Ste 130, Bend, OR 97702-3241 | 2020-10-23 |
| 1962000554 | Dawn Marks | Peer Specialist | 21440 Se Stark St, Gresham, OR 97030-2024 | 2020-10-15 |
| 1679188080 | Michelle Marie Bunkers | Peer Specialist | 20517 Jacklight Ln, Bend, OR 97702-2971 | 2020-09-11 |
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1528677820 | Charice Monette | Peer Specialist | 4151 Kacey Cir Ne, Salem, OR 97305-4504 | 2020-07-23 |
| 1841810322 | Ariana Lee May | Peer Specialist | 1601 Olive St Apt 1008, Eugene, OR 97401-3985 | 2020-04-24 |
| 1982237236 | Jessica M Montoya | Peer Specialist | 235 Se Knowledge St, Prineville, OR 97754-2362 | 2020-02-14 |
| 1134752579 | Lisa Kennedy | Peer Specialist | 132 Ne B St # 24, Grants Pass, OR 97526-2114 | 2020-02-13 |
| 1730711953 | Michael Anthony Duran | Peer Specialist | 1515 Hill St Se, Albany, OR 97322-6715 | 2020-02-05 |
| Find all providers with the same taxonomy | ||||
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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.