Mrs Kimberly Ann Kelly, LPC is a
Clinic/center - Multi-specialty based in Tupelo, Mississippi. Mrs Kimberly Ann Kelly is licensed to practice in Mississippi (license number 1923) and her current practice location is
2164 Southridge Dr, Tupelo, Mississippi. She can be reached at her office (for appointments etc.) via phone at
(662) 760-0115.
NPI number for Mrs Kimberly Ann Kelly is 1992944870 and her current mailing address is 238 County Road 2446, Guntown, Mississippi. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1992944870.
Healthcare Provider's Profile
| Full Name | Mrs Kimberly Ann Kelly |
|---|
| Gender | Female |
|---|
| Speciality | Clinic/center - Multi-specialty |
|---|
| Location | 2164 Southridge Dr, Tupelo, Mississippi |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1992944870
- Provider Enumeration Date: 02/17/2009
- Last Update Date: 01/29/2025
Medical Identifiers
Medical identifiers for Mrs Kimberly Ann Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1992944870 | NPI | - | NPPES |
| 01437332 | Medicaid | MS | |
| 83-4622726 | Other | MS | COMMERCIAL |
| 001437332 | Medicaid | MS | |
| 83-4622726 | Medicaid | MS | |
| 01376867 | Medicaid | MS | |
| 001376867 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | 1923 (Mississippi) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | 1923 (Mississippi) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | 1923 (Mississippi) | 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 Kimberly Ann 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 |
|---|
Mrs Kimberly Ann Kelly, LPC
238 County Road 2446,
Guntown, MS 38849-9106
Ph: (662) 760-0115 | Mrs Kimberly Ann Kelly, LPC
2164 Southridge Dr,
Tupelo, MS 38801-6417
Ph: (662) 760-0115 |
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