THERESA ANN KELLY (NPI# 1548639891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548639891 |
| Entity Type | Individual |
| Full Name | THERESA ANN KELLY |
| Credential | M.A.,LPC,LCPC |
| Practice Address |
2245 W Estes Ave Chicago IL 60645-3403 |
| Practice Telephone | 7735626230 |
| Mailing Telephone | 7735626230 |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2015-09-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 180009878 | IL | Behavioral Health & Social Service Providers |
| N | 101Y00000X | Counselor | 178006846 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720527146 | Theresa Waurzyniak Kelly | Social Worker | 10785 S Saginaw St, Bldg. E, Ste. A, Grand Blanc, MI 48439-7003 | 2017-02-17 |
| 1689021685 | Theresa Eileen Kelly | Pharmacist | 507 E Woodlawn Ave, La Grange Park, IL 60526-1983 | 2016-05-19 |
| 1679844104 | Theresa Kelly | Physician Assistant | 43200 Dequindre Rd, Ste104, Sterling Hts, MI 48314-1707 | 2012-01-13 |
| 1548433998 | Theresa J. Kelly | Occupational Therapist | 5101 Medical Dr, San Antonio, TX 78229-4801 | 2008-04-08 |
| 1003087776 | Theresa A Kelly | Nurse Anesthetist, Certified Registered | 601 Park St, Honesdale, PA 18431-1445 | 2008-03-20 |
| 1225153059 | Theresa Ann Kelly | Pharmacist | 453 E. 111th St., Kansas City, MO 64131 | 2007-03-20 |
| 1477663763 | Theresa Ann Kelly | Psychologist | 2401 W Main St, Marion, IL 62959-1188 | 2006-08-30 |
| 1073572483 | Theresa Louise Kelly | Physician Assistant | 4692 Brownsboro Road, Winston-salem, NC 27106-3410 | 2006-03-23 |
| Street Address |
2245 W ESTES AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60645-3403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306210117 | Brenda Ann Jarred | Massage Therapist | 6510 N Claremont Ave, 3rd Floor, Chicago, IL 60645 | 2015-11-17 |
| 1568850881 | Kathryn A Pusateri | Counselor | 6554 North Rockwell Street, Suite 2, Chicago, IL 60645 | 2015-01-09 |
| 1447671169 | Miriam Belsky | Speech-Language Pathologist | 6524 N Mozart St Apt 3, Chicago, IL 60645 | 2013-12-23 |
| 1972880912 | Harold B Shrifter | Internal Medicine | 6450 N. California Ave., Chicago, IL 60645 | 2011-11-04 |
| 1306159710 | Amy M Carl | Social Worker | 3003 W Touhy, Council for Jewish Elderly, Chicago, IL 60645 | 2010-07-15 |
| 1699919043 | Boguslawa Romanowska | Physical Therapist | 6211 N. Milwaukee, Chicago, IL 60645 | 2009-04-29 |
| 1851539522 | Yoela Tamara Holman | Speech-Language Pathologist | 3056 W. Sherwin Ave., Chicago, IL 60645 | 2009-02-03 |
| 1285884577 | Ingrid Forsberg | Nurse Practitioner | 7510 N Western, Chicago, IL 60645 | 2008-09-24 |
| 1881842581 | S Fatima Md Sc | Internal Medicine | 7133 North Ridge Blvd., Chicago, IL 60645 | 2008-09-05 |
| 1013173467 | A Place for Children | Early Intervention Provider Agency | 2425 W Pratt, Chicago, IL 60645 | 2008-08-05 |
| Find all providers in zip 60645 | ||||
| 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 |
|---|---|---|---|---|
| 1366058075 | Allyssa Rose Bertram | Counselor | 4055 W Peterson Ave Ste 202, Chicago, IL 60646-6183 | 2020-09-17 |
| 1952914707 | Tara Ufer | Counselor | 400 W Deming Pl Apt 9g, Chicago, IL 60614-1702 | 2020-08-30 |
| 1104439694 | Alisa Williams | Counselor | 409 E 62nd St, Chicago, IL 60637-6097 | 2020-08-25 |
| 1730791492 | Forward Intentions Therapy LLC | Counselor | 1309 N Ashland Ave, Chicago, IL 60622-8744 | 2020-08-23 |
| 1184232183 | Isaac William Samuelson | Counselor | 3058 W Cortland St Apt 2, Chicago, IL 60647-5075 | 2020-07-16 |
| 1346861242 | Hannah Conner | Counselor | 2756 N Pine Grove Ave Apt 705, Chicago, IL 60614-6167 | 2020-05-01 |
| 1881215804 | Pamela Ann Brazelton-sykes | Counselor | Pioneer Gardens Supportive Living, 3800 S King Dr, Chicago, IL 60653 | 2020-04-30 |
| 1619597259 | Charles Chevell Hurt | Counselor | 1606 W Wallen Ave Apt 1, Chicago, IL 60626-6592 | 2020-04-23 |
| 1851911580 | Jessica C Baran | Counselor | 5200 S Blackstone Ave Apt 401, Chicago, IL 60615-6011 | 2020-04-22 |
| 1659907350 | Lauren Graner | Counselor | 2845 N Sheridan Rd # 708, Chicago, IL 60657-7227 | 2020-03-14 |
| Find all providers in CHICAGO | ||||
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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.