Kelly, Thomas E.

Kelly, Thomas E. is an sole proprietor health care provider with primary practice located at 108 S Minnesota Ave Ste 102 , Saint Peter MN 56082-2557. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Kelly, Thomas E. can be contacted via phone (507) 484-2400.

Contact Information

Primary practice address
108 S Minnesota Ave Ste 102 Saint Peter MN 56082-2557
Phone: (507) 484-2400
Fax: (507) 934-5220
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 3386-125 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 00871 Iowa
Behavioral Health & Social Service Providers / Professional 101YP2500X 00018 Minnesota
Behavioral Health & Social Service Providers / Professional 101YP2500X 180-003674 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP5043 Minnesota

Profile Details

NPI number 1972607562
LBN Legal business name Kelly, Thomas E.
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 12th, 2006
Last updated Mar 17th, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972607562 NPPES
Minnesota MEDICAID 1972607562

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