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General NPI Number Information
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NPI Number | 1053492397
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Entity Type | Individual
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Provider Name | MICHAEL E KELLEY PHD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 1500 E MEDICAL CENTER DR
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City | ANN ARBOR
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State | MI
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Zip | 48109-5000
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Country | US
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Telephone | 734-936-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 3621 S STATE ST
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City | ANN ARBOR
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State | MI
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Zip | 48108-1633
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Country | US
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Telephone | 734-647-5299
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-05-2534
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-05-2534
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-05-2534
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-05-2534
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY 1234
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License Number State | ME
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Taxonomy #6
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY8664
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 760
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License Number State | NE
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Taxonomy #8
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 019167
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License Number State | PA
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Taxonomy #9
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301019270
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License Number State | MI
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