JUDY KELLY (NPI# 1861771677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861771677 |
| Entity Type | Individual |
| Full Name | JUDY KELLY |
| Practice Address |
224 West Graham Ave Lake Elsinore CA 92530 |
| Mailing Address |
411 Hamlin Cir Corona CA 92879-6106 |
| Practice Telephone | 9513181351 |
| Mailing Telephone | 9513409302 |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2015-03-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | IMF73071 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457368714 | Judy A Kelly | Counselor | 229 E 28 St, Apt Ld, New York, NY 10016-8565 | 2006-08-01 |
| 1316946494 | Judy Kelly | Nurse Practitioner | St. Mary's Hosp. Fam. Hlth. Ctr. At Johnsville, 7 Timmerman Avenue, St. Johnsville, NY 13452 | 2005-07-20 |
| 1366616211 | Judy Kelly | Chiropractor | 1925 E Belt Line Rd, #503, Carrollton, TX 75006-5801 | 2008-04-22 |
| 1326055690 | Judy Kelly | Social Worker | 210 N Hammes Ave, Suite 103, Joliet, IL 60435-6680 | 2006-08-01 |
| Street Address |
224 WEST GRAHAM AVE |
| City | LAKE ELSINORE |
| State | CA |
| Zip Code | 92530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801479 | Mercedes Samantha Hamilton | Licensed Psychiatric Technician | 18465 Grand Ave, Lake Elsinore, CA 92530 | 2020-08-17 |
| 1700423779 | Karrene Louise Stanard | Peer Specialist | 31764 Casino Drive, Suite 300, Lake Elsinore, CA 92530 | 2019-12-09 |
| 1972149961 | Danielle Cravalho | Student in an Organized Health Care Education/Training Program | 31964 Mission Trail, Suite B, Lake Elsinore, CA 92530 | 2019-11-25 |
| 1952825648 | R.e. Levi Dental Corporation | Dentist | 32235 Mission Trail # 8, Lake Elsinore, CA 92530 | 2017-08-03 |
| 1144760729 | Alfred Metwashla | Pharmacist | 18269 Collier Ave, Lake Elsinore, CA 92530 | 2017-03-02 |
| 1750788733 | Roxanne Martinez | Case Manager/Care Coordinator | 31764 Casino Drive, Lake Elsinore, CA 92530 | 2014-11-19 |
| 1871870907 | Bryan Tuan Tran | Pharmacist | 160 Diamond Drive, Lake Elsinore, CA 92530 | 2011-11-03 |
| 1043590821 | Katherynn Elizabeth Williams | Marriage & Family Therapist | 600 Central Ave Ste 201, Lake Elsinore, CA 92530 | 2011-08-24 |
| 1427343813 | Patrick Chern | Pharmacist | 18287 Collier Ave., Lake Elsinore, CA 92530 | 2011-06-14 |
| 1700036290 | Van Lou Investments | Pharmacy | 31571 Canyon Estates Dr. #118, Lake Elsinore, CA 92530 | 2008-09-22 |
| Find all providers in zip 92530 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891345310 | Konnor Feese | Marriage & Family Therapist | 208 S Nebraska St, Lake Elsinore, CA 92530-1894 | 2019-09-17 |
| 1053965111 | Dyrola Amantine | Marriage & Family Therapist | 31772 Casino Dr Ste A, Lake Elsinore, CA 92530-4502 | 2019-07-27 |
| 1437663895 | Heidi Ann Overbey | Marriage & Family Therapist | 31760 Casino Dr Ste 100, Lake Elsinore, CA 92530-4561 | 2017-11-21 |
| 1588173025 | Jennifer Hyatt | Marriage & Family Therapist | 31772 Casino Dr Ste B, Lake Elsinore, CA 92530-4502 | 2017-09-27 |
| 1548666720 | Kristine Nunn | Marriage & Family Therapist | 31760 Casino Dr, Lake Elsinore, CA 92530-4561 | 2014-11-14 |
| 1043590821 | Katherynn Elizabeth Williams | Marriage & Family Therapist | 600 Central Ave Ste 201, Lake Elsinore, CA 92530 | 2011-08-24 |
| 1386960029 | Benedict W Choi | Marriage & Family Therapist | 31681 Riverside Dr Ste L, Lake Elsinore, CA 92530-7815 | 2010-04-19 |
| 1801091699 | Larry Dewitt Hairston | Marriage & Family Therapist | 15 Ponte Brava, Lake Elsinore, CA 92532-0233 | 2007-06-20 |
| 1710021316 | Saira Prudencio | Marriage & Family Therapist | 31946 Mission Trl Ste B, Lake Elsinore, CA 92530-4539 | 2007-02-16 |
| 1023157914 | Marsha Diane Mathews | Marriage & Family Therapist | 31772 Casino Dr, Lake Elsinore, CA 92530-4502 | 2007-02-06 |
| Find all providers in LAKE ELSINORE | ||||
| City | LAKE ELSINORE |
| Zip Code | 92530 |
Please comment or provide details below to improve the information on JUDY 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.