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Individual
MAURA KELLY
Active
Individual
MAURA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
10768
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821490129
—
MA
Enumeration date
09/18/2014
Last updated
05/14/2025
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