Dr Thomas E Kelly, PSYD is a
Psychologist - Clinical based in Saint Peter, Minnesota. Dr Thomas E Kelly is licensed to practice in Minnesota (license number LP5043) and his current practice location is
108 S Minnesota Ave Ste 102, Saint Peter, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(507) 484-2400.
NPI number for Dr Thomas E Kelly is 1972607562 and his current mailing address is 2399 Ariel St N, Suite D, Maplewood, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1972607562.
Healthcare Provider's Profile
| Full Name | Dr Thomas E Kelly |
|---|
| Gender | Male |
|---|
| Speciality | Psychologist - Clinical |
|---|
| Location | 108 S Minnesota Ave Ste 102, Saint Peter, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1972607562
- Provider Enumeration Date: 09/12/2006
- Last Update Date: 03/17/2018
Medical Identifiers
Medical identifiers for Dr Thomas E Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1972607562 | NPI | - | NPPES |
| 1972607562 | Medicaid | MN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | 3386-125 (Wisconsin) | Secondary |
| 101YP2500X | Counselor - Professional | 00871 (Iowa) | Secondary |
| 101YP2500X | Counselor - Professional | 00018 (Minnesota) | Secondary |
| 101YP2500X | Counselor - Professional | 180-003674 (Illinois) | Secondary |
| 103TC0700X | Psychologist - Clinical | LP5043 (Minnesota) | 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. Dr Thomas E Kelly is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Thomas E Kelly, PSYD
2399 Ariel St N, Suite D,
Maplewood, MN 55109-2203
Ph: (651) 770-1311 | Dr Thomas E Kelly, PSYD
108 S Minnesota Ave Ste 102,
Saint Peter, MN 56082-2557
Ph: (507) 484-2400 |
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