MR. TIMOTHY KEVIN KELLY (NPI# 1710082979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710082979 |
| Entity Type | Individual |
| Full Name | MR. TIMOTHY KEVIN KELLY |
| Credential | M.S. |
| Practice Address |
10163 Se Sunnyside Rd Ste 490 Clackamas OR 97015-5720 |
| Mailing Address |
4454 Ne Mason St Portland OR 97218-1739 |
| Practice Telephone | 5036533451 |
| Mailing Telephone | 5032547996 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
OR C0220 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720561608 | Timothy Kelly | Social Worker | 25a Vreeland Rd, Florham Park, NJ 07932-1910 | 2018-09-07 |
| 1942525928 | Timothy Anton Kelly | Home Health | 7954 Brooklyn Boulavard, 7954, Brooklyn Park, MN 55445 | 2010-04-01 |
| 1003026261 | Timothy Richard Kelly | Psychiatry & Neurology | 510 Azalea Dr Ste 200, Oxford, MS 38655-6903 | 2007-05-23 |
| 1700953163 | Timothy James Kelly | Chiropractor | 1038 Washington Street, Fairfield, CA 94533-5545 | 2006-11-29 |
| 1063592558 | Timothy P Kelly | Chiropractor | 3098 Piedmont Rd Ne Ste 430, Atlanta, GA 30305-2600 | 2006-10-17 |
| 1588653281 | Timothy Lynn Kelly | Dentist | 1600 Mountain View Rd, Suite 104, Rapid City, SD 57702-4381 | 2005-10-17 |
| 1992798169 | Timothy L Kelly | Anesthesiology | 831 Nw Council Dr, Suite 300, Gresham, OR 97030-3721 | 2005-08-23 |
| 1497758825 | Timothy G Kelly | Ophthalmology | 1915 Tradd Ct, Wilmington, NC 28401-6638 | 2005-05-31 |
| 1073140497 | Timothy Stephen Kelly | Student in an Organized Health Care Education/Training Program | 1 Gustave L Levy Pl # 1149, New York, NY 10029-6504 | 2020-03-25 |
| 1649805888 | Timothy Dwyer Kelly | Student in an Organized Health Care Education/Training Program | 13001 E 17th Pl, Aurora, CO 80045-2570 | 2020-03-09 |
| Street Address |
10163 SE SUNNYSIDE RD STE 490 |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-5720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013020767 | Susan Seely Hook | Marriage & Family Therapist | 10163 Se Sunnyside Rd Ste 490, Clackamas, OR 97015-5720 | 2006-08-16 |
| 1548733017 | Tyler Casey | Pharmacist | 10163 Se Sunnyside Rd Ste 490, Clackamas, OR 97015-5720 | 2019-01-08 |
| 1992061436 | Bob Wynn | Psychiatry & Neurology | 10163 Se Sunnyside Rd Ste 490, Clackamas, OR 97015-5720 | 2012-04-10 |
| 1528385812 | Katelyn Snyder | Counselor | 10163 Se Sunnyside Rd Ste 490, Clackamas, OR 97015-5720 | 2010-04-26 |
| 1225229396 | Han-chun Liang | Psychiatry & Neurology | 10163 Se Sunnyside Rd Ste 490, Clackamas, OR 97015-5720 | 2007-08-05 |
| 1467534909 | Darian Vincent Minkunas | Psychiatry & Neurology | 10163 Se Sunnyside Rd Ste 490, Clackamas, OR 97015-5720 | 2006-10-20 |
| 1366554123 | Jeanne Louise Ewen | Social Worker | 10163 Se Sunnyside Rd Ste 490, Clackamas, OR 97015-5720 | 2006-08-31 |
| 1174633929 | Johnny Corrace Walker | Social Worker | 10163 Se Sunnyside Rd Ste 490, Clackamas, OR 97015-5720 | 2006-08-30 |
| 1720194392 | Douglas K O'dell | Counselor | 10163 Se Sunnyside Rd Ste 490, Clackamas, OR 97015-5720 | 2006-08-23 |
| 1750495875 | Thomas Jess Smurthwaite | Psychologist | 10163 Se Sunnyside Rd Ste 490, Clackamas, OR 97015-5720 | 2006-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932748787 | Karen Rene Harris | Counselor | 15480 Se 82nd Dr Ste B, Clackamas, OR 97015-9633 | 2019-12-26 |
| 1093280729 | Lily Armstrong | Counselor | 10822 Se 82nd Ave Ste K, Clackamas, OR 97086-7658 | 2018-10-09 |
| 1548753759 | David George Hamilton | Counselor | 13726 Se 97th Ave, Clackamas, OR 97015-8651 | 2018-06-12 |
| 1710477641 | Hanna Victoria Thompson | Counselor | 8645 Se Sunnybrook Blvd # 100, Clackamas, OR 97015-6841 | 2018-05-16 |
| 1619219623 | Amelia Elizabeth Mackle | Counselor | 8800 Se Sunnyside Rd Ste 257s, Clackamas, OR 97015-5738 | 2013-03-18 |
| 1053625970 | Martha Janet Lacy | Counselor | 12901 Se 97th Ave Ste 340, Clackamas, OR 97015-7903 | 2010-08-03 |
| 1629296744 | Anne M. James | Counselor | 13568 Se 97th Ave Ste 206, Clackamas, OR 97015-6668 | 2007-04-23 |
| 1447317912 | Carol Ann Miille | Counselor | 9136 St. Helens St, Suite 175, Clackamas, OR 97015-1376 | 2007-01-03 |
| 1285728907 | Scott Anthony Leahing | Counselor | 10180 Se Sunnyside Rd., Clackamas, OR 97015-9764 | 2006-10-03 |
| 1942842570 | Haley Julia Bennett | Counselor | 12901 Se 97th Ave Ste 340, Clackamas, OR 97015-7903 | 2019-10-15 |
| Find all providers in CLACKAMAS | ||||
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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.