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Tim Ray Kelly
Peer Specialist in Lincoln City, Oregon
NPI 1003535386

Tim Ray Kelly is a Peer Specialist based in Lincoln City, OR. Tim Ray Kelly practices in Lincoln City, OR. The NPI Number for Tim Ray Kelly is 1003535386 and holds a License No. THW000106995 (Oregon).

The current practice location address for Tim Ray Kelly is 1221 Nw Highway 101 Ste A, Lincoln City, OR and can be reached out via phone at 442-244-1336.

Location: 1221 Nw Highway 101 Ste A, Lincoln City, OR, 97367-3351
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003535386
Provider Name
Tim Ray Kelly
Credential
Provider Entity Type
Individual
Gender
Male
Address
1221 Nw Highway 101 Ste A, Lincoln City, OR, 97367-3351
Phone Number
442-244-1336
Fax Number
Provider Enumeration Date
08/22/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1221 Nw Highway 101 Ste A
City
Lincoln City
State
Oregon
Zip
97367-3351
Phone Number
442-244-1336
Fax Number
person
Provider Business Mailing Address Details
Address
1221 Nw Highway 101 Ste A
City
Lincoln City
State
Oregon
Zip
97367-3351
Phone Number
442-244-1336
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
THW000106995 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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