MARY TERESA KELLY (NPI# 1073020590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073020590 |
| Entity Type | Individual |
| Full Name | MARY TERESA KELLY |
| Credential | MA |
| Practice Address |
726 Cherryvale Rd Boulder CO 80303-2911 |
| Practice Telephone | 3035945240 |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-01-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
NLC.0010159 | CO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | STATE REGISTRATION NUMBER | NLC.0010159 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558844811 | Mary Elizabeth Kelly | Social Worker | 97 Libbey Industrial Pkwy Ste 301, Weymouth, MA 02189-3110 | 2018-09-12 |
| 1215410790 | Mary Jane Kelly | Dietitian, Registered | 1046 E Elgenia Ave, West Covina, CA 91790-1318 | 2018-09-11 |
| 1972040459 | Mary A Kelly | Registered Nurse | 116 N Lake Ave, Albany, NY 12206-2710 | 2017-01-23 |
| 1073904215 | Mary Kelly | Registered Nurse | 3145 State Route 718, Troy, OH 45373-8908 | 2015-02-10 |
| 1174924054 | Mary Kelly | Nurse Practitioner | 14435 15th Ave, Whitestone, NY 11357-2407 | 2014-09-10 |
| 1306058714 | Mary Catherine Kelly | Nurse Practitioner | 275 Riverside Ave, Riverside, CT 06878-2313 | 2007-05-06 |
| 1134340086 | Mary Kris Kelly | Nurse Practitioner | 1 Gustave L Levy Pl # 1030, New York, NY 10029-6500 | 2007-05-01 |
| 1518187772 | Mary Ann Kelly | Dietary Manager | 6448 Hallee Rd Ste 9, Joshua Tree, CA 92252-1908 | 2007-04-27 |
| 1003036583 | Mary Anne Kelly | Marriage & Family Therapist | 105 Sunnyside Ave, Piedmont, CA 94611-4419 | 2007-04-26 |
| 1902920549 | Mary Kathleen Kelly | Nurse Practitioner | 4221 Penn Ave, Pittsburgh, PA 15224-1307 | 2007-03-19 |
| Street Address |
726 CHERRYVALE RD |
| City | BOULDER |
| State | CO |
| Zip Code | 80303-2911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821583725 | Ariel Meyers | Physical Therapist | Frasier Meadows Retirement Community Dept. of Rehab, 350 Ponca Place, Boulder, CO 80303 | 2018-06-25 |
| 1831683838 | Sandra Ramsey | Occupational Therapist | 350 Ponca, Boulder, CO 80303 | 2018-06-22 |
| 1770085243 | Laura Michelle Boucher | Physical Medicine & Rehabilitation | 5387 Manhattan Cir, Ste 200, Boulder, CO 80303 | 2018-03-01 |
| 1396255568 | Colorado Sports Chiropractic | Chiropractor | 1440 28th St Ste 2, Boulder, CO 80303 | 2017-10-02 |
| 1932618782 | Michele Adrienne Packard | Psychologist | 4410 Arapahoe Suite 140, Boulder, CO 80303 | 2017-09-25 |
| 1134505290 | Bili Blanket Baby, LLC | Durable Medical Equipment & Medical Supplies | 4450 Arapahoe Ave, Suite 100, Boulder, CO 80303 | 2015-07-30 |
| 1710378146 | Jonathan Gardiner Lears | Counselor | 5600 Arapahoe Ave, Suite 102, Boulder, CO 80303 | 2015-02-06 |
| 1114316965 | Northstar Transitions | Substance Abuse Rehabilitation Facility | 75 Manhattan Dr., Suites 110 and 208 Northstar Transitions, Boulder, CO 80303 | 2015-01-16 |
| 1902226434 | Integrated Dermatology of Boulder, Pllc | Dermatology | 2935 Baseline Road, Suite 201, Boulder, CO 80303 | 2014-04-23 |
| 1396160081 | Melissa Rupert | Physical Therapist | 975 Waite Drive, Boulder, CO 80303 | 2014-03-04 |
| Find all providers in zip 80303 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205466 | Sara Horn | Counselor | 4650 White Rock Cir Apt 12, Boulder, CO 80301-5373 | 2020-08-16 |
| 1669095618 | Allison Margaret Leddy Villarreal | Counselor | 737 29th St Ste 200f, Boulder, CO 80303-2474 | 2020-05-26 |
| 1265053961 | Positive Regard Psychotherapy Pllc | Counselor | 3102 Gamow Ln, Boulder, CO 80301-5465 | 2020-05-04 |
| 1154953776 | Willow Mae Arlenea | Counselor | 4500 19th St Lot 379, Boulder, CO 80304-0663 | 2020-02-11 |
| 1336779925 | Lisa Wallace | Counselor | 2769 Iris Ave Ste 107, Boulder, CO 80304-4405 | 2020-01-22 |
| 1952952764 | Lauren Bleu Northrup | Counselor | 170 Seminole Dr, Boulder, CO 80303-4227 | 2019-09-23 |
| 1750947289 | Shelly Froehlich | Counselor | 1637 28th St Ste 201, Boulder, CO 80301-1001 | 2019-05-09 |
| 1003470139 | Kim Ann Merrill | Counselor | 6658 Gunpark Dr Ste 201, Boulder, CO 80301-3375 | 2019-04-24 |
| 1477019222 | Elizabeth Ann Maher | Counselor | 4949 Broadway St Ste 201, Boulder, CO 80304-0578 | 2019-02-18 |
| 1124592225 | Stepheny Antrobus | Counselor | 100 Arapahoe Lane, Suite 12, Boulder, CO 80302 | 2019-01-11 |
| Find all providers in BOULDER | ||||
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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.