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Individual
MR. TIMOTHY KELLY SR.
Active
Individual
MR. TIMOTHY KELLY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.183151
OH
104100000X
Social Worker
S.2202740-TRNE
OH
171M00000X
Case Manager/Care Coordinator
Primary
—
—
175T00000X
Peer Specialist
—
OH
Other
Enumeration date
01/17/2019
Last updated
08/08/2024
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