KELLEY ELIZABETH STALEY (NPI# 1891311593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891311593 |
| Entity Type | Individual |
| Full Name | KELLEY ELIZABETH STALEY |
| Practice Address |
6095 Pine Mountain Rd Nw Ste 105 Kennesaw GA 30152-3332 |
| Mailing Address |
4440 Crestwicke Pointe Atlanta GA 30319-1081 |
| Practice Telephone | 6782177529 |
| Mailing Telephone | 7703597577 |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-06-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184652984 | Kelley Kathleen Staley | Pediatrics | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2006-06-29 |
| Street Address |
6095 PINE MOUNTAIN RD NW STE 105 |
| City | KENNESAW |
| State | GA |
| Zip Code | 30152-3332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366970782 | Ellyce Diana Payne | Counselor | 6095 Pine Mountain Rd Nw Ste 105, Kennesaw, GA 30152-3332 | 2017-05-30 |
| 1265039804 | Alice Kim | Counselor | 6095 Pine Mountain Rd Nw Ste 105, Kennesaw, GA 30152-3332 | 2020-10-06 |
| 1720699416 | Sarah Brainard | Social Worker | 6095 Pine Mountain Rd Nw Ste 105, Kennesaw, GA 30152-3332 | 2020-08-14 |
| 1922624519 | Alyxandra Paige | Counselor | 6095 Pine Mountain Rd Nw Ste 105, Kennesaw, GA 30152-3332 | 2020-06-19 |
| 1578187753 | Karen E Michael | Counselor | 6095 Pine Mountain Rd Nw Ste 105, Kennesaw, GA 30152-3332 | 2020-06-03 |
| 1982226346 | Ashley A Jones | Counselor | 6095 Pine Mountain Rd Nw Ste 105, Kennesaw, GA 30152-3332 | 2020-05-08 |
| 1104455591 | Monique Hill | Counselor | 6095 Pine Mountain Rd Nw Ste 105, Kennesaw, GA 30152-3332 | 2020-04-07 |
| 1669008033 | Abigail Doreen Miller | Counselor | 6095 Pine Mountain Rd Nw Ste 105, Kennesaw, GA 30152-3332 | 2020-03-18 |
| 1639719412 | Marilyn Veal | Counselor | 6095 Pine Mountain Rd Nw Ste 105, Kennesaw, GA 30152-3332 | 2020-01-09 |
| 1639738842 | Madeline Mcgarrah | Counselor | 6095 Pine Mountain Rd Nw Ste 105, Kennesaw, GA 30152-3332 | 2019-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821647124 | Ashley Dover | Nurse Practitioner | 1300 Ridenour Blvd, Suite 300, Kennesaw, GA 30152 | 2019-09-09 |
| 1205306891 | Lashanda Denise Moore | Nurse Practitioner | 1600 Kennesaw Due West Rd Nw #205, Kennesaw, GA 30152 | 2018-11-27 |
| 1265901094 | Focused Loving Home Care Services LLC | In Home Supportive Care | 2151 Marne Glen Nw, Kennesaw, GA 30152 | 2018-11-22 |
| 1083199152 | Raven Ashley Thomas | Behavioral Analyst | 1619 Collins Rd Nw Ste 500, Kennesaw, GA 30152 | 2018-09-25 |
| 1821592593 | Eseovhe Egborge PC | Clinic/Center | 1600 Kennesaw Due West Rd Nw Ste 205, Kennesaw, GA 30152 | 2018-03-19 |
| 1184143059 | Kennesaw Mountain Dental Associates | Dentist | 1815 Old 41 Hwy, Ste 310, Kennesaw, GA 30152 | 2017-09-12 |
| 1265955983 | Deborah Ruth Stern Compton | Registered Nurse | 1291 Stanley Rd., Kennesaw, GA 30152 | 2017-07-25 |
| 1912452939 | Mak Anesthesia Holdings LLC | Anesthesiology | 1300 Ridenour Blvd., Ste. 300, Kennesaw, GA 30152 | 2016-08-19 |
| 1528430279 | Tineka Nichol Wyckoff | Counselor | 1967 Lake Heights Circle, Kennesaw, GA 30152 | 2015-10-21 |
| 1669753992 | American Current Care Pa | Clinic/Center | 2953 Cobb Parkway, Suite 400, Kennesaw, GA 30152 | 2011-08-31 |
| Find all providers in zip 30152 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962027 | Evan Kauper | Counselor | 2002 Smith Dr Nw, Kennesaw, GA 30144-1851 | 2020-11-02 |
| 1851918999 | Faith and Hope Counseling Services LLC | Counselor | 1074 Cobb Place Blvd Nw # 301, Kennesaw, GA 30144-3671 | 2020-07-05 |
| 1003436338 | Christopher M Hall | Counselor | 2332 Holden Way Nw, Kennesaw, GA 30144-6063 | 2020-04-16 |
| 1114428695 | Foster4love Inc. | Counselor | 3745 Cherokee St Nw Ste 602, Kennesaw, GA 30144-6785 | 2018-02-21 |
| 1366970782 | Ellyce Diana Payne | Counselor | 6095 Pine Mountain Rd Nw Ste 105, Kennesaw, GA 30152-3332 | 2017-05-30 |
| 1366807505 | Lisa Harwell | Counselor | 1301 Shiloh Rd Nw Ste 811, Kennesaw, GA 30144-7156 | 2015-12-15 |
| 1528430279 | Tineka Nichol Wyckoff | Counselor | 1967 Lake Heights Circle, Kennesaw, GA 30152 | 2015-10-21 |
| 1811390594 | Lisa Karla Parker | Counselor | 1055 Shiloh Rd Nw, Ste. 311, Kennesaw, GA 30144 | 2014-10-08 |
| 1497099428 | Anna Mistretta-bradley | Counselor | 1301 Shiloh Rd Nw Ste 1810, Kennesaw, GA 30144-7171 | 2012-11-15 |
| 1871890269 | Kevin F Daly | Counselor | 5205 Stilesboro Rd Nw Ste 225, Kennesaw, GA 30152-7748 | 2011-02-21 |
| Find all providers in KENNESAW | ||||
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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.