ERIN MARIE KELLY (NPI# 1548728140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548728140 |
| Entity Type | Individual |
| Full Name | ERIN MARIE KELLY |
| Credential | LCPC |
| Practice Address |
12630 Ann St Blue Island IL 60406-1704 |
| Practice Telephone | 7737108620 |
| Mailing Telephone | 7737108620 |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2019-03-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 180.011146 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417505884 | Erin Elizabeth Kelly | Occupational Therapist | 88 Cherry St, Floral Park, NY 11001-3342 | 2019-08-29 |
| 1962976936 | Erin Kelly | Physical Therapist | 718 N Main St Unit 18, Gunnison, CO 81230-2412 | 2019-01-14 |
| 1215416409 | Erin Kelly | Occupational Therapist | 1887 Barthgate Ave, Bronx, NY 10457 | 2018-08-09 |
| 1285147421 | Erin E Kelly | Social Worker | 311 S Craig St Ste 300, Pittsburgh, PA 15213-3731 | 2017-11-09 |
| 1568974871 | Erin Kelly | Speech-Language Pathologist | 875 Poplar Church Rd Ste 320, Camp Hill, PA 17011-2203 | 2017-10-26 |
| 1790238566 | Erin Kelly | Dietitian, Registered | 4580 Lincklaen Rd, Cazenovia, NY 13035-9756 | 2016-07-28 |
| 1154733525 | Erin Kelly | Case Manager/Care Coordinator | 1150 S Olive St, Los Angeles, CA 90015-2211 | 2014-05-20 |
| 1780028464 | Erin Shigeko Kelly | General Practice | 2708 Greenfield Ave, Los Angeles, CA 90064-4032 | 2013-04-24 |
| 1619218997 | Erin Kelly | Counselor | 4440 Beard Ave S Apt 308, Minneapolis, MN 55410-1465 | 2013-03-11 |
| 1174811038 | Erin N Kelly | Counselor | 2205-a S Main, Las Cruces, NM 88005 | 2011-07-13 |
| Street Address |
12630 ANN ST |
| City | BLUE ISLAND |
| State | IL |
| Zip Code | 60406-1704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780205708 | Cook County | Family Medicine | 12757 S. Western Ave, Blue Island, IL 60406 | 2020-04-30 |
| 1942842810 | Blue Island Smiles PC | Dentist | 12059 Western Avenue, Blue Island, IL 60406 | 2019-10-12 |
| 1609438738 | Maisha Safford | Developmental Therapist | 2262 W. 120th Place, Blue Island, IL 60406 | 2019-06-28 |
| 1891279709 | Renjith Thomas | Physical Therapy Assistant | Therapy Department, 1546 W Water Stret, Blue Island, IL 60406 | 2018-09-18 |
| 1982182994 | Lifehouse Health Group,llc | Clinic/Center | 14127 Levitt Ave, Dixmoor, IL 60406 | 2018-08-01 |
| 1063923159 | Sarah Lynn Presser | Speech-Language Pathologist | 2975 W Broadway, Blue Island, IL 60406 | 2017-10-17 |
| 1174070676 | Aunt Martha's Youth Service Center | Clinic/Center | 12139 S. Western Ave, Blue Island, IL 60406 | 2016-09-01 |
| 1427429141 | Pamela Kilcrease | Case Manager/Care Coordinator | 2247 119th Street, Apt 6, Blue Island, IL 60406 | 2015-10-08 |
| 1639587025 | D2 Dental At Oak Street, P.C. | Dentist | 3046 West 127th Street, Blue Island, IL 60406 | 2014-07-29 |
| 1700299658 | Daniel Ahrens | Optometrist | 13114 S Western Ave, Blue Island, IL 60406 | 2014-06-09 |
| Find all providers in zip 60406 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851999080 | Linda D Odaniel | Counselor | 12904 Division St Apt 2a, Blue Island, IL 60406-3420 | 2020-10-09 |
| 1023476769 | Ngozi Harris | Counselor | 12510 Vincennes Rd, Unit 4, Blue Island, IL 60406-1674 | 2016-02-09 |
| 1578064036 | Sierra L Parham-gantt | Counselor | 13136 Western Ave, Blue Island, IL 60406-2423 | 2018-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922813 | Valerie Ann Taylor | Counselor | 1230 N Washington Ave, Batavia, IL 60510-1369 | 2020-11-07 |
| 1073114088 | Astrid Larsen | Counselor | 2317 Timberline Trl, Woodstock, IL 60098-8759 | 2020-11-05 |
| 1932708690 | Mucci World Management Inc,. | Counselor | 7913 171st St, Tinley Park, IL 60477-3244 | 2020-10-22 |
| 1679172373 | Alexander Czop | Counselor | 1250 Chestnut Ave, Wilmette, IL 60091-1616 | 2020-10-22 |
| 1427656859 | Mica Coleman | Counselor | 5800 Allemong Dr, Matteson, IL 60443-1108 | 2020-10-16 |
| 1386242873 | Kelly Mann | Counselor | 301 S Henry St, Ashkum, IL 60911-7119 | 2020-10-15 |
| 1245838549 | Erika Leigh Heatley | Counselor | 32w755 Albert Dr, East Dundee, IL 60118-3202 | 2020-10-09 |
| 1366058075 | Allyssa Rose Bertram | Counselor | 4055 W Peterson Ave Ste 202, Chicago, IL 60646-6183 | 2020-09-17 |
| 1952914707 | Tara Ufer | Counselor | 400 W Deming Pl Apt 9g, Chicago, IL 60614-1702 | 2020-08-30 |
| 1104439694 | Alisa Williams | Counselor | 409 E 62nd St, Chicago, IL 60637-6097 | 2020-08-25 |
| Find all providers with the same taxonomy | ||||
| City | BLUE ISLAND |
| Zip Code | 60406 |
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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.