MS. TINA MARIE KELLY (NPI# 1407219355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407219355 |
| Entity Type | Individual |
| Full Name | MS. TINA MARIE KELLY |
| Credential | LMFT |
| Practice Address |
1144 Sonoma Ave Suite 104 Santa Rosa CA 95405-4812 |
| Practice Telephone | 7075468584 |
| Practice Fax Number | 7075463937 |
| Mailing Telephone | 7075468584 |
| Mailing Fax Number | 7075463937 |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-03-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | LMFT85659 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295364115 | Tina M. Kelly | Behavior Technician | 145 Moreland Ave, Waterbury, CT 06705-2928 | 2020-04-02 |
| 1073066908 | Tina Kelly | Occupational Therapist | 21 Brittany Blvd, Marlton, NJ 08053-5513 | 2016-07-27 |
| 1629577721 | Tina Marie Kelly | Dental Hygienist | 427 N Michigan Ave, Saginaw, MI 48602-4314 | 2018-02-05 |
| 1518253251 | Tina Marie Kelly | Nurse Practitioner | 433 Copperfield Blvd Ne, Concord, NC 28025-2405 | 2011-06-21 |
| 1104014455 | Tina Vu Kelly | Optometrist | 3223 Duke St, Suite B3, Alexandria, VA 22314-4586 | 2007-10-11 |
| Street Address |
1144 SONOMA AVE SUITE 104 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-4812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609866888 | Jeffrey D. Bean | Dentist | 1144 Sonoma Ave, St. 102, Santa Rosa, CA 95405-4812 | 2005-10-27 |
| 1952837155 | Dental Group of Emine Loxley, Dds, Inc | Clinic/Center | 1144 Sonoma Ave, #107, Santa Rosa, CA 95405-4812 | 2017-05-08 |
| 1033594783 | Edward A Biery | Psychologist | 1144 Sonoma Ave, Ste 104, Santa Rosa, CA 95405-4812 | 2015-07-23 |
| 1366820474 | Jennifer E. Blum | Psychologist | 1144 Sonoma Ave, 104, Santa Rosa, CA 95405-4812 | 2015-05-08 |
| 1467847103 | Rafael Miguel Diaz | Psychologist | 1144 Sonoma Ave, Suite 104, Santa Rosa, CA 95405-4812 | 2015-03-31 |
| 1518370519 | Dena Nicole Dimond | Nurse Practitioner | 1144 Sonoma Ave, Ste 119, Santa Rosa, CA 95405-4812 | 2014-06-06 |
| 1992123905 | Elizabeth Cassanos | Psychologist | 1144 Sonoma Ave, Santa Rosa, CA 95405-4812 | 2014-04-07 |
| 1679882880 | Dorothy Marie Mandel | Psychologist | 1144 Sonoma Ave, Ste 117, Santa Rosa, CA 95405-4812 | 2010-10-05 |
| 1225346398 | Tina Louise Sandoval-dyer | Marriage & Family Therapist | 1144 Sonoma Ave, Suite 117, Santa Rosa, CA 95405-4812 | 2010-09-22 |
| 1760717441 | North Coast Faculty Medical Group Inc. | Otolaryngology | 1144 Sonoma Ave, 101, Santa Rosa, CA 95405-4812 | 2009-10-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386269918 | Debra Gold | Marriage & Family Therapist | 835 Piner Rd, Santa Rosa, CA 95403-2063 | 2020-06-09 |
| 1619590700 | Cameron Craig Lutchansky | Marriage & Family Therapist | 2235 Mercury Way Ste 240, Santa Rosa, CA 95407-5443 | 2020-05-22 |
| 1689294498 | Pamela Jo Peringer | Marriage & Family Therapist | 2345 Morningside Cir, Santa Rosa, CA 95405-9132 | 2020-04-22 |
| 1467004028 | Megan Barajas | Marriage & Family Therapist | 3440 Mendocino Ave, Santa Rosa, CA 95403-2221 | 2019-07-14 |
| 1275193674 | Marie Romano | Marriage & Family Therapist | 3434 Mendocino Ave Bldg C, Santa Rosa, CA 95403-2274 | 2019-06-18 |
| 1851956932 | Amy Theodore | Marriage & Family Therapist | 2455 Bennett Valley Rd Ste B201, Santa Rosa, CA 95404-5667 | 2019-05-05 |
| 1609335314 | Heidi Diebel | Marriage & Family Therapist | 9291 Oak Trail Cir, Santa Rosa, CA 95409 | 2019-03-13 |
| 1114413952 | Jordan Morrison | Marriage & Family Therapist | 1260 N Dutton Ave Ste 230, Santa Rosa, CA 95401-7161 | 2018-07-05 |
| 1568958437 | Bianca Avina | Marriage & Family Therapist | 95 Montgomery Dr. #112, Santa Rosa, CA 95404 | 2018-07-03 |
| 1174012710 | Humanidad Therapy and Education Services | Marriage & Family Therapist | 95 Montgomery Dr Ste 112, Santa Rosa, CA 95404-6617 | 2018-05-09 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
Please comment or provide details below to improve the information on MS. TINA MARIE KELLY.
| 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.