Healthcare Provider Details

I. General information

NPI: 1477697878
Provider Name (Legal Business Name): ROBERT O. KELLEY M.ED.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 LEE HOOK RD
LEE NH
03824-6415
US

IV. Provider business mailing address

225 LEE HOOK RD
LEE NH
03824-6415
US

V. Phone/Fax

Practice location:
  • Phone: 603-682-8265
  • Fax: 603-679-5869
Mailing address:
  • Phone: 603-682-8265
  • Fax: 603-679-5869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number017
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number096
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: