MARY TERESA KELLY MA NPI 1073020590

NPI Information

NPI: 1073020590
Provider Name: MARY TERESA KELLY, MA
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
726 CHERRYVALE RD
BOULDER, CO
ZIP 80303
Phone: (303) 594-5240
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Mary Teresa Kelly, MA is a professional counselor in Boulder, CO. Mary Teresa Kelly, MA NPI is 1073020590. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

726 CHERRYVALE RD
BOULDER, CO
ZIP 80303-911
Phone: (303) 594-5240

The enumeration date for this NPI number is 1/5/2018 and was last updated on 1/5/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	NLC.0010159	COLORADO	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NLC.0010159	OTHER	COLORADO	STATE REGISTRATION NUMBER

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

NPI Synchronization or Removal

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