Mr Timothy Kelly Sr, is a
Case Manager/care Coordinator based in Independence, Ohio. Mr Timothy Kelly Sr is licensed to practice in * (Not Available) (license number ) and his current practice location is
6200 Rockside Woods Blvd N Ste 305, Independence, Ohio. He can be reached at his office (for appointments etc.) via phone at
(234) 410-5775.
NPI number for Mr Timothy Kelly Sr is 1083188643 and his current mailing address is 21231 Wilmore Ave, Euclid, Ohio. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1083188643.
Healthcare Provider's Profile
| Full Name | Mr Timothy Kelly Sr |
|---|
| Gender | Male |
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| Speciality | Case Manager/care Coordinator |
|---|
| Location | 6200 Rockside Woods Blvd N Ste 305, Independence, Ohio |
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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: 1083188643
- Provider Enumeration Date: 01/17/2019
- Last Update Date: 08/08/2024
Medical Identifiers
Medical identifiers for Mr Timothy Kelly Sr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1083188643 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CDCA.183151 (Ohio) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | S.2202740-TRNE (Ohio) | Secondary |
| 175T00000X | Peer Specialist | (Ohio) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | 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. Mr Timothy Kelly Sr 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 |
|---|
Mr Timothy Kelly Sr,
21231 Wilmore Ave,
Euclid, OH 44123-2823
Ph: (234) 410-5775 | Mr Timothy Kelly Sr,
6200 Rockside Woods Blvd N Ste 305,
Independence, OH 44131-2343
Ph: (234) 410-5775 |
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