Kelley, Gary Bernard
Kelley, Gary Bernard is an sole proprietor health care provider with primary practice located at 6605 Limberlost Ct , Solon OH 44139-3100. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Counseling. Behavioral Health & Social Service Providers / Counseling is his primary health care specialty. Kelley, Gary Bernard can be contacted via phone (449) 349-5445.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 2187 | Ohio |
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | 2187 | Ohio |
Behavioral Health & Social Service Providers / School | 103TS0200X | 2187 | Ohio |
Behavioral Health & Social Service Providers / Counseling | 103TC1900X | 2187 | Ohio |
Profile Details
NPI number | 1013028653 |
---|---|
LBN Legal business name | Kelley, Gary Bernard |
Credentials | PH.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 31st, 2006 |
Last updated | Oct 25th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1013028653 | NPPES |
Ohio | MEDICAID | 0320996 |
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