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TIMOTHY EUGENE KELLEY MA NPI 1710223698


NPI Information

NPI: 1710223698
Provider Name: TIMOTHY EUGENE KELLEY, MA
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
313 WEST THIRD STREET, SUITE 204
LA JUNTA, CO
ZIP 81050
Phone: (719) 469-0799
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Timothy Eugene Kelley, MA is a professional counselor in La Junta, CO. Timothy Eugene Kelley, MA NPI is 1710223698. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

313 WEST THIRD STREET, SUITE 204
LA JUNTA, CO
ZIP 81050
Phone: (719) 469-0799

The enumeration date for this NPI number is 12/20/2012 and was last updated on 12/20/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental Health3479COLORADONo
2101YP2500XCounselorProfessional3479COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1$$$$$$$$$MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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