MR. PAUL A KELLY SR. (NPI# 1164790960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164790960 |
| Entity Type | Individual |
| Full Name | MR. PAUL A KELLY SR. |
| Practice Address |
3071 South Donouvan Street Wasilla AK 99654 |
| Mailing Address |
Po Box 879645 Wasilla AK 99687-9645 |
| Practice Telephone | 9073882566 |
| Mailing Telephone | 9073882566 |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417366105 | Paul Kelly | Counselor | 1 Railroad Ave, Closter, NJ 07624-1240 | 2014-08-06 |
| 1457782658 | Paul Kelly | Counselor | 481 8th Avenue, Suite 520, New York Pathways, New York, NY 10001 | 2013-12-13 |
| 1609071836 | Paul D. Kelly | Chiropractor | 932 N Mitchell St, Suite 6, Cadillac, MI 49601-1285 | 2007-06-18 |
| 1316079924 | Paul Owen Kelly | Internal Medicine | 4713 State Rd, Drexel Hill, PA 19026-4727 | 2007-03-09 |
| 1629112685 | Paul Anthony Kelly | Acupuncturist | 152 Tamarack Cir, Skillman, NJ 08558-2021 | 2007-02-16 |
| 1831253533 | Paul Colin Kelly | Physical Therapist | 113 E 23rd St, New York, NY 10010-4507 | 2006-12-20 |
| 1841352895 | Paul Edward Kelly | Counselor | 3698 Seabass Rd, Decatur, GA 30034-6954 | 2006-12-15 |
| 1538230255 | Paul David Kelly | Pharmacist | 270 Lafayette Rd, Seabrook, NH 03874-4542 | 2006-11-13 |
| 1548297930 | Paul F Kelly | Internal Medicine | 56 Franklin St., 3rd Floor, Waterbury, CT 06706-1253 | 2006-06-28 |
| 1326670308 | Paul Kevin Kelly | Social Worker | 151 Burrs Ln, Dix Hills, NY 11746-6052 | 2020-02-07 |
| Street Address |
3071 SOUTH DONOUVAN STREET |
| City | WASILLA |
| State | AK |
| Zip Code | 99654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922463512 | Brittney Punt | Counselor | 5730 E Pilgrim Ct, St A, Wasilla, AK 99654-1419 | 2015-12-23 |
| 1255767307 | Emily Barry | Counselor | 301 E Danna Ave, Wasilla, AK 99654-6422 | 2013-09-20 |
| 1477994937 | William C Petty | Counselor | 351 W Swanson Ave, Suite 4, Wasilla, AK 99654-6853 | 2013-07-12 |
| 1386269439 | Alexandria Camille Palmer | Counselor | 7010 E Bogard Rd, Wasilla, AK 99654-4711 | 2020-06-15 |
| 1972137529 | Casey Ackerman | Counselor | 1075 S Check St Ste 208, Wasilla, AK 99654-8067 | 2020-02-22 |
| 1023584596 | Talia Green | Counselor | 133 E Swanson Ave, Wasilla, AK 99654-7025 | 2018-10-22 |
| 1023567831 | Dennis Gall | Counselor | 133 E Swanson Ave, Wasilla, AK 99654-7025 | 2016-09-22 |
| 1558783472 | Lee Ann Mitchell | Counselor | 7010 E Bogard Rd, Wasilla, AK 99654 | 2014-01-12 |
| 1902141567 | Celeste Alecia Long | Counselor | 5461 E Mayflower Ln Ste 1, Wasilla, AK 99654-7892 | 2012-12-06 |
| 1396882023 | Thomas A. Lytle | Counselor | 1700 Bogard Rd, Ste 201, Wasilla, AK 99654-6533 | 2007-01-31 |
| Find all providers in WASILLA | ||||
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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.