| Scott Kelly & Associates Pc | |
|
3125 W Main St Kalamazoo MI 49006-2997 | |
| (269) 488-5905 | |
| Not Available |
| Full Name | Scott Kelly & Associates Pc |
|---|---|
| Speciality | Psychologist |
| Location | 3125 W Main St, Kalamazoo, Michigan |
| Authorized Official Name and Position | Scott Kelly (PRESIDENT) |
| Authorized Official Contact | 2694885905 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott Kelly & Associates Pc 3125 W Main St Kalamazoo MI 49006-2997 Ph: (269) 488-5905 | Scott Kelly & Associates Pc 3125 W Main St Kalamazoo MI 49006-2997 Ph: (269) 488-5905 |
| NPI Number | 1396885604 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7911081062 |
|---|---|
| Medicare Enrollment ID | O20080227000588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396885604 | NPI | - | NPPES |
| 6301006856 | Other | MI | MI PSYCHOLOGIST LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301006856 (Michigan) | Primary |
| Provider Name | Scott A Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184892051 PECOS PAC ID: 4587563820 Enrollment ID: I20040106000162 |
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