- Practice location
- 2297 Knowles Flat RD, Eden, VT 05652
- Phone
- 802-635-9595
- Fax
- 802-635-7755
- Last updated
- July 8, 2007
Kenneth Gregory Kelly is a Psychologist, Clinical based in Eden, VT. Kenneth Gregory Kelly practices in Eden, VT and has the professional credentials of PSYCHOLOGIST-MA. The NPI Number for Kenneth Gregory Kelly is 1205052487 and holds a License No. 47-0000157 (VT). The current practice location address for Kenneth Gregory Kelly is 2297 Knowles Flat RD, Eden, VT 05652 and can be reached out via phone at 802-635-9595 and via fax at 802-635-7755.
Provider Profile Details
- NPI Number
- 1205052487
- Provider Name
- Kenneth Gregory Kelly
- Credential
- PSYCHOLOGIST-MA
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 2297 Knowles Flat RD, Eden, VT 05652
- Phone Number
- 802-635-9595
- Fax Number
- 802-635-7755
- Primary Taxonomy
- Psychologist, Clinical · 103TC0700X
- Sole Proprietor
- Yes
- Other Names
- Prof. K G Kelly (Professional Name)
- Provider Enumeration Date
- April 17, 2007
- Last Update Date
- July 8, 2007
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 2297 Knowles Flat RD
Eden, VT 05652 - City
- Eden
- State
- Vermont
- Zip
- 05652
- Phone Number
- 802-635-9595
- Fax Number
- 802-635-7755
Provider Business Mailing Address Details
- Address
- Po Box 1401
Morrisville, VT 05661-1401 - City
- Morrisville
- State
- VT
- Zip
- 05661-1401
- Phone Number
- 802-635-9595
- Fax Number
- 802-635-7755
License Information
- License Number
- 47-0000157
- License State
- VT
- Taxonomy
- Psychologist, Clinical · 103TC0700X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Psychologist, Clinical providers near Eden, VT
View all Psychologist, Clinical providers in Eden →Frequently Asked Questions
What is the NPI number of Mr. Kenneth G Kelly, PSYCHOLOGIST-MA?
The NPI number of Mr. Kenneth G Kelly, PSYCHOLOGIST-MA is 1205052487. It was assigned on April 17, 2007 and is currently active in the NPPES registry.
What is the specialty of Mr. Kenneth G Kelly, PSYCHOLOGIST-MA?
Mr. Kenneth G Kelly, PSYCHOLOGIST-MA is registered under the primary taxonomy Psychologist, Clinical (code 103TC0700X), licensed in VT under license number 47-0000157.
Where does Mr. Kenneth G Kelly, PSYCHOLOGIST-MA practice?
The practice location is 2297 Knowles Flat RD, Eden, VT 05652. The office can be reached at 802-635-9595 (phone) or 802-635-7755 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1205052487 directly on the NPPES registry website.