=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225280142
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBYN KELLY THERAPIST
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/22/2008
-----------------------------------------------------
Last Update Date | 11/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11260 CHESTER RD STE 728
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45246-4048
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-630-2328
-----------------------------------------------------
Fax | 513-854-9019
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11260 CHESTER RD STE 728
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45246-4048
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-449-0445
-----------------------------------------------------
Fax | 513-854-9019
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | CSW008433
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | I.1101613-SUPV
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------