MRS. KIM J KELLY (NPI# 1730457193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730457193 |
| Entity Type | Individual |
| Full Name | MRS. KIM J KELLY |
| Credential | LCAS |
| Practice Address |
200 S Pollock St Selma NC 27576-3062 |
| Mailing Address |
205 Westwood Dr Greenville NC 27834-5015 |
| Practice Telephone | 9199656770 |
| Practice Fax Number | 9199650196 |
| Mailing Telephone | 2524121963 |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2016-02-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 2526 | NC | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
2526 | NC | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
2526 | NC | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992198584 | Kim Marie Kelly | Behavioral Analyst | 20 Tater St, Mont Vernon, NH 03057-1315 | 2015-03-06 |
| 1851630412 | Kim A Kelly | Counselor | 2528 Oak St, Jacksonville, FL 32204-4504 | 2013-02-01 |
| 1689950800 | Kim C Kelly | Speech-Language Pathologist | 678 Cantiague Rock Rd, Jericho, NY 11753-1401 | 2011-11-02 |
| 1538302799 | Kim Darrell Kelly | Naturopath | 1363 Burgundy Rd, Encinitas, CA 92024-1847 | 2009-04-16 |
| 1740380633 | Kim Erin Kelly | Counselor | 333 S Juniper St, #115, Escondido, CA 92025-4924 | 2006-09-22 |
| 1578585501 | Kim Michelle Kelly | Family Medicine | 12710 Se Division Street, Portland, OR 97236 | 2006-07-25 |
| 1790119857 | Kim Marie Kelly | Pharmacist | 1401 Bombing Range Rd, West Richland, WA 99353-8001 | 2013-08-26 |
| 1457453326 | Kim H Kelly | Registered Nurse | 111 S Front St, Harrisburg, PA 17101-2010 | 2006-09-02 |
| Street Address |
200 S POLLOCK ST |
| City | SELMA |
| State | NC |
| Zip Code | 27576-3062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639491806 | The Lawson's House | Durable Medical Equipment & Medical Supplies | 200 S Pollock St, Selma, NC 27576-3062 | 2010-02-16 |
| 1255878708 | Stephanie Fu | Counselor | 200 S Pollock St, Selma, NC 27576-3062 | 2017-01-23 |
| 1346796299 | Kimberly Davis | Social Worker | 200 S Pollock St, Selma, NC 27576-3062 | 2016-08-31 |
| 1013369644 | Callie Smith | Social Worker | 200 S Pollock St, Selma, NC 27576-3062 | 2016-07-07 |
| 1669883096 | Sarah Craig | Social Worker | 200 S Pollock St, Selma, NC 27576-3062 | 2014-05-20 |
| 1932535135 | Tiffani Mccormick | Counselor | 200 S Pollock St, Selma, NC 27576-3062 | 2013-09-19 |
| 1467790253 | Judith Batamuliza Bushaija | Counselor | 200 S Pollock St, Selma, NC 27576-3062 | 2013-01-29 |
| 1376841668 | Carolina Support Services, Inc | Community/Behavioral Health | 200 S Pollock St, Selma, NC 27576-3062 | 2011-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588057913 | Andre Williams | Technician, Other | 110 Aj Lane, Wendell, NC 27576 | 2015-03-10 |
| 1184024010 | Jeffrey Ray Watson | In Home Supportive Care | 200 South Massey Street, Selma, NC 27576 | 2014-08-28 |
| 1407109390 | Community and Senior Services of Johnston Cou | Non-emergency Medical Transport (VAN) | 1050 West Noble Street, Selma, NC 27576 | 2012-10-17 |
| 1992951321 | A Step Above Group Home | Residential Treatment Facility, Emotionally Disturbed Children | 512 Webb St, Selma, NC 27576 | 2008-08-18 |
| 1972707222 | Preferred Home Care, Inc. | Home Health | 1100- B S. Pollock Street, Selma, NC 27576 | 2007-06-12 |
| 1700992922 | Waccamaw Pain Partners Pa | Physical Medicine & Rehabilitation | 4033 Hwy 17 Bypass, Suite 108, Murrells Inlet, SC 27576 | 2006-08-21 |
| 1578663472 | Jill Liberty Sonner | Dentist | 1111 S Pollock St, Selma, NC 27576 | 2006-09-22 |
| 1851937148 | Stevens House of Hope, Inc | Adult Companion | 1002 W Waddell St, Selma, NC 27576-2028 | 2019-11-21 |
| 1316501232 | Right At Home Home Healthcare | Home Health | 101 N Green St, Selma, NC 27576-2111 | 2019-04-25 |
| 1053682815 | Michael Na Daniels | Counselor | 105 Winter Ct, Selma, NC 27576-2189 | 2012-01-25 |
| Find all providers in zip 27576 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053682815 | Michael Na Daniels | Counselor | 105 Winter Ct, Selma, NC 27576-2189 | 2012-01-25 |
| 1598034118 | Lagreta Williams Cameron | Counselor | 1420a S Pollock St, Selma, NC 27576-3404 | 2011-12-28 |
| 1043485014 | James Adam Lassiter | Counselor | 602 S Sumner St, Selma, NC 27576-2947 | 2008-04-29 |
| 1760494785 | Wanda W Walton | Counselor | 1202 Richmond Street, Selma, VA 24474 | 2006-08-12 |
| 1487164877 | Prodigy Healthcare Inc. | Counselor | 3125 Wright St, Selma, CA 93662-2429 | 2017-10-11 |
| 1275952574 | Laura Ann Caldarera | Counselor | 1420a S Pollock St, Selma, NC 27576-3404 | 2014-04-15 |
| 1932535135 | Tiffani Mccormick | Counselor | 200 S Pollock St, Selma, NC 27576-3062 | 2013-09-19 |
| 1639374655 | Linda Chewning Nelson | Counselor | 1101 River Rd, Selma, NC 27576-3611 | 2007-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841384 | Karen Yvette Johnson | Counselor | 2500 Saint Christopher Cir Sw Apt 1, Wilson, NC 27893-4474 | 2020-11-05 |
| 1407456163 | Fallon Middle Williams | Counselor | 127 Westview Meadows Dr, Goldsboro, NC 27530-9589 | 2020-10-30 |
| 1205436268 | Josette Hoffman Skinner | Counselor | 51 Park Dr Sw, Concord, NC 28027-7029 | 2020-10-29 |
| 1962002931 | Mind Over Mood | Counselor | 115 Carlos Drive, Garysburg, NC 27831 | 2020-10-29 |
| 1528668043 | Hope and Wellness Counseling Pllc | Counselor | 4017 S Nc Highway 11, Wallace, NC 28466-6111 | 2020-10-26 |
| 1205436730 | Joy Elise Chiles | Counselor | 8505 Mount Valley Ln, Raleigh, NC 27613-6931 | 2020-10-26 |
| 1588264006 | Jocelyn S Whitfield | Counselor | 1279 William Beale Rd, Pendleton, NC 27862-7015 | 2020-10-26 |
| 1225637796 | Cindy Verdoorn | Counselor | 10831 Pineville Rd Unit 9, Pineville, NC 28134-8137 | 2020-10-25 |
| 1700485430 | Travis William Richardson | Counselor | 3 Doctors Park Ste 3g, Asheville, NC 28801-4531 | 2020-10-23 |
| 1952900615 | Eastern Trauma & Recovery Counseling Service | Counselor | 11814 Us 64a, Spring Hope, NC 27882-9637 | 2020-10-22 |
| Find all providers with the same taxonomy | ||||
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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.