DR. KELLY JEAN SMITH (NPI# 1013539477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013539477 |
| Entity Type | Individual |
| Full Name | DR. KELLY JEAN SMITH |
| Credential | PH.D., LPC |
| Practice Address |
1717 Taylor Ave Racine WI 53403-2405 |
| Practice Telephone | 2626386771 |
| Mailing Telephone | 2626386771 |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-05-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
7421-125 | WI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518566371 | Kelly Rae Smith | Nurse Practitioner | 13402 Creekview Rd, Prospect, KY 40059-9028 | 2020-10-22 |
| 1447877899 | Kelly Smith | Dental Hygienist | 7700 Sw Garden Home Rd Apt 24, Portland, OR 97223-7496 | 2020-07-01 |
| 1346720893 | Kelly Smith | Licensed Vocational Nurse | 512 S Kearny, Clarendon, TX 79226 | 2018-08-15 |
| 1568976751 | Kelly Elizabeth Smith | Counselor | 216 Gilmer Street, Lebanon, VA 24266 | 2017-11-27 |
| 1013437870 | Kelly Dennis Smith | Public Health or Welfare | 211 Oakmont Dr, New Orleans, LA 70128-3624 | 2017-06-22 |
| 1164955498 | Kelly Ghislaine Smith | Student in an Organized Health Care Education/Training Program | 171 Old Chester Rd, Essex Fells, NJ 07021-1624 | 2017-04-04 |
| 1588026975 | Kelly Therese Smith | Specialist/Technologist | 344 S Maple Ave #2a, Oak Park, IL 60302 | 2016-03-24 |
| 1790168326 | Kelly Smith | Counselor | 545 Sw 26th St, Oklahoma City, OK 73109-6740 | 2015-07-01 |
| 1518353341 | Kelly Smith | Nurse Practitioner | 2232 Wilborn Ave Ste D, South Boston, VA 24592-1662 | 2015-04-08 |
| 1265830491 | Kelly Sue Smith | Speech-Language Pathologist | 210 Starpine Pl Unit A, Prescott, AZ 86303-7017 | 2014-12-22 |
| Street Address |
1717 TAYLOR AVE |
| City | RACINE |
| State | WI |
| Zip Code | 53403-2405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356441018 | Susan F Mickel | Psychologist | 1717 Taylor Ave, Racine, WI 53403-2405 | 2006-09-23 |
| 1811595671 | Wallace Edward Brandies Jr. | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2020-10-14 |
| 1811503204 | Sarah Moran | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2020-09-21 |
| 1417577230 | Alexandra Kim Kies | Social Worker | 1717 Taylor Ave, Racine, WI 53403-2405 | 2020-04-22 |
| 1336785336 | Selena Lamont Letteer | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2019-11-25 |
| 1841832474 | Dora Ann Caldwell | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2019-10-15 |
| 1043876451 | Darren L Taylor | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2019-05-13 |
| 1689230179 | Kathleen B Campeau | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2019-05-10 |
| 1689131534 | Melissa Hellen | Social Worker | 1717 Taylor Ave, Racine, WI 53403-2405 | 2019-02-27 |
| 1699232546 | Jelena Jones | Social Worker | 1717 Taylor Ave, Racine, WI 53403-2405 | 2019-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124676259 | Quality Care LLC | Clinic/Center | 2051 Mead St, Racine, WI 53403 | 2019-09-02 |
| 1073999355 | Wisconsin Lutheran Child & Family Service, Inc. | Social Worker | 6150 Taylor Avenue, Racine, WI 53403 | 2015-08-10 |
| 1457780496 | Pheynell Branch | Counselor | 1650 Wasington Ave, Racine, WI 53403 | 2013-11-08 |
| 1811278054 | Michelle Gloria Parisot | Psychologist | 1320 Wisconsin Ave., Racine, WI 53403 | 2011-09-01 |
| 1720372022 | Katie Hagen | Social Worker | 1717 Taylor Avenue, Racine, WI 53403 | 2011-06-03 |
| 1043431570 | Rita S Harris | Physical Therapy Assistant | Lakeshore Manor 1320 Wisconsin Avenue, Racine, WI 53403 | 2007-05-01 |
| 1336281336 | Linda J Hockensmith | Occupational Therapist | 4214 Sheridan Road, Racine, WI 53403 | 2007-02-13 |
| 1851447387 | Richard John Kemper | Dentist | 1509 Washington Ave, Racine, WI 53403 | 2007-01-26 |
| 1689760332 | Lester Leslie Higgenbottom | Counselor | 1820 Arlington Ave, Racine, WI 53403 | 2006-10-04 |
| 1114942315 | Access Medical Center, LLC | Clinic/Center | 4216 Old Green Bay Rd, Racine, WI 53403 | 2006-07-12 |
| Find all providers in zip 53403 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881220408 | Denise Petrelli-holst | Counselor | 2515 1st St, Racine, WI 53403-9649 | 2020-03-15 |
| 1609106616 | Natalie Caye Fecht | Counselor | 4635 Erie St, Racine, WI 53402-2818 | 2010-01-14 |
| 1699933036 | Theresa Dewalt | Counselor | 1220 Mound Ave Ste 304, Racine, WI 53404-3350 | 2008-05-31 |
| 1609046788 | Portis Marriage and Children Counseling Clinic, LLC | Counselor | 5801 Washington Ave Ste 103, Racine, WI 53406-4057 | 2008-03-05 |
| 1255340642 | Michael Allen Boticki | Counselor | 1220 Mound Ave Ste 301, Racine, WI 53404-3350 | 2006-08-05 |
| 1447204953 | Amy Sprague Champeau | Counselor | 102 10th St, Racine, WI 53403-1513 | 2006-05-20 |
| 1841832474 | Dora Ann Caldwell | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2019-10-15 |
| 1285005082 | John Vianney Muweesi | Counselor | 800 Wisconsin Ave, Racine, WI 53403-1526 | 2015-10-19 |
| 1194101550 | Alexander Jeske | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2015-08-07 |
| 1558615773 | Gregory Lautz | Counselor | 1717 Taylor Ave, Racine, WI 53403-2405 | 2012-11-09 |
| Find all providers in RACINE | ||||
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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.