MRS. KIMBERLY ANN KELLY (NPI# 1992944870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992944870 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY ANN KELLY |
| Credential | LPC |
| Practice Address |
114 E Bolton St Pontotoc MS 38863-1506 |
| Practice Telephone | 6627600115 |
| Practice Fax Number | 6625960428 |
| Mailing Telephone | 6627600115 |
| Mailing Fax Number | 6625960428 |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2016-06-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 01376867 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083252878 | Kimberly Anne Kelly | Nurse Practitioner | 3056 Hickory St, Yorktown Heights, NY 10598-2734 | 2019-12-12 |
| 1023503919 | Kimberly Kelly | Counselor | 1382 Bull Lea Rd, Lexington, KY 40511-1247 | 2018-06-25 |
| 1265812085 | Kimberly Kelly | Counselor | 80 Kleyona Ave, Phoenixville, PA 19460-2568 | 2015-06-06 |
| 1144600115 | Kimberly Ann Kelly | Dietitian, Registered | 3550 Ballina Canyon Rd, Encino, CA 91436-4108 | 2015-06-04 |
| 1922403955 | Kimberly C. Kelly | Behavioral Analyst | 62 Lowell St Ste 5, Manchester, NH 03101-1607 | 2014-11-04 |
| 1710390828 | Kimberly Kelly | Speech-Language Pathologist | 1313 Southside Cir, Nashville, TN 37212-2442 | 2014-06-05 |
| 1669727186 | Kimberly Kelly | Social Worker | 2750 Sutterville Road, Sacramento, CA 95820 | 2012-07-20 |
| 1174833966 | Kimberly Sue Kelly | Psychologist | 630 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2010-10-14 |
| 1245460120 | Kimberly A Kelly | Pharmacist | 8571 Rivers Ave, North Charleston, SC 29406-9208 | 2009-07-24 |
| 1487815346 | Kimberly Dionne Kelly | Nurse Practitioner | 700 19th St S # 111-i, Birmingham, AL 35233-1927 | 2008-06-23 |
| Street Address |
114 E BOLTON ST |
| City | PONTOTOC |
| State | MS |
| Zip Code | 38863-1506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033510391 | The Journey Resource Center | Counselor | 114 E Bolton St, Pontotoc, MS 38863-1506 | 2014-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003429176 | Erik Goodwin | Chiropractor | 1 Goodwin Drive, Pontotoc, MS 38863 | 2020-08-28 |
| 1003455379 | Billie Jay Holloway | Technician | 1357 Hwy 9 South, Pontotoc, MS 38863 | 2020-01-03 |
| 1689185597 | Southern Physical and Aquatic Therapy, P.a. | Clinic/Center | 369 Peoples Drive, Pontotoc, MS 38863 | 2017-10-18 |
| 1699290460 | Jamie Michelle Holloway | Nurse Practitioner | 1374 Cooke Road, Pontotoc, MS 38863 | 2017-08-13 |
| 1235673351 | Carla Chism | Speech-Language Pathologist | 2564 Highway 345, Pontotoc, MS 38863 | 2016-12-08 |
| 1669924379 | Stephanie N Watson | Nurse Practitioner | 351 Peoples Dr. # A, Pontotoc, MS 38863 | 2016-10-28 |
| 1003285461 | Timothy R Watson | Nurse Practitioner | Acute Care and Family Clininc 351 Peoples Dr, 351 Peoples Dr, Pontotoc, MS 38863 | 2015-09-16 |
| 1770995938 | Mississippi Professional Counseling Associates | Social Worker | 356a East Oxford Street, Pontotoc, MS 38863 | 2014-05-22 |
| 1376852525 | Kenneth E Prewett | Pharmacist | 170 Highway 15 N, Pontotoc, MS 38863 | 2010-10-05 |
| 1801105051 | Thomas Keith Guntharp | Pharmacist | 170 Highway 15 North, Pontotoc, MS 38863 | 2010-10-05 |
| Find all providers in zip 38863 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326142969 | Janice Lee Waller | Counselor | 339 Legion Ln, Pontotoc, MS 38863-8978 | 2006-09-12 |
| 1063705853 | Ekaterini Papadimitriou | Counselor | 339 Legion Ln, Pontotoc, MS 38863-8978 | 2011-05-26 |
| 1003136672 | Brett Tyler Dillard | Counselor | 39 Lafayette St, Pontotoc, MS 38863-2837 | 2010-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275134868 | Charsie Duvall | Counselor | 1302 Pleasant Grove Chapparal Rd, Waynesboro, MS 39367-7415 | 2020-11-02 |
| 1356940977 | Joy Wheeler | Counselor | 8631 Pigeon Roost Rd, Olive Branch, MS 38654-1298 | 2020-10-23 |
| 1427655364 | Nurturing Hands | Counselor | 296 Beauvoir Rd Ste 100-156, Biloxi, MS 39531-4051 | 2020-10-05 |
| 1033726930 | Katherine Campbell | Counselor | 796 Us 45 Alternate South, Starkville, MS 39759 | 2020-09-25 |
| 1245846807 | Rochelle Grice | Counselor | 6871 Wrenwood Dr, Horn Lake, MS 38637-7710 | 2020-09-18 |
| 1265047237 | Tori Weatherspoon | Counselor | Timber Hills Mental Health Services, 2441- A Co Rd 501, Ripley, MS 38663 | 2020-09-15 |
| 1629681531 | Kayla Denea White | Counselor | 6 Professional Pkwy, Ridgeland, MS 39157-4113 | 2020-08-28 |
| 1184242711 | New Life Goals, LLC | Counselor | 504 Cooper Rd, Jackson, MS 39212-4704 | 2020-07-09 |
| 1902423312 | Joseph Edward Mingo II | Counselor | 513 Lee St, Mccomb, MS 39648 | 2020-07-01 |
| 1477179315 | Fredna Leigh Georgen | Counselor | 615 Highway 469 N, Florence, MS 39073-8928 | 2020-06-16 |
| 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.