Healthcare Provider Details

I. General information

NPI: 1225280142
Provider Name (Legal Business Name): ROBYN KELLY THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11260 CHESTER RD STE 728
CINCINNATI OH
45246-4048
US

IV. Provider business mailing address

11260 CHESTER RD STE 728
CINCINNATI OH
45246-4048
US

V. Phone/Fax

Practice location:
  • Phone: 870-630-2328
  • Fax: 513-854-9019
Mailing address:
  • Phone: 513-449-0445
  • Fax: 513-854-9019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW008433
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1101613-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: