# THOMAS JOHN KELLY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1477030823
- **Gender:** Man
- **Credential:** LADC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | LC3444 | ME | Yes |

## Other

- **Enumeration date:** 07/27/2018
- **Last updated:** 07/27/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 207LA0401X | — | ME |