Mrs Shannon Kathleen Kelley, PMHNP, LCSW, CASAC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Syracuse, New York. Her current practice location is
713 Harrison St, Syracuse, New York. You can reach out to her office (for appointments etc.) via phone at
(315) 464-7655.
Mrs Shannon Kathleen Kelley is licensed to practice in New York (license number 403004) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1902089238.
Healthcare Provider's Profile
Full Name | Mrs Shannon Kathleen Kelley |
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Gender | Female |
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Speciality | |
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Experience | Years |
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Location | 713 Harrison St, Syracuse, New York |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mrs Shannon Kathleen Kelley attended and graduated from in
NPI Data:
- NPI Number: 1902089238
- Provider Enumeration Date: 12/10/2007
- Last Update Date: 02/25/2021
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Mrs Shannon Kathleen Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1902089238 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 082228-1 (New York) | Secondary |
163W00000X | Registered Nurse | 740606 (New York) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 403004 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Shannon Kathleen Kelley is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Shannon Kathleen Kelley, PMHNP, LCSW, CASAC 713 Harrison St, Syracuse, NY 13210-2305 Ph: (315) 464-7655 | Mrs Shannon Kathleen Kelley, PMHNP, LCSW, CASAC 713 Harrison St, Syracuse, NY 13210-2305 Ph: (315) 464-7655 |
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