Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Timothy Kelly Sr.

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1083188643

Mr. Timothy Kelly Sr. is an Addiction (Substance Use Disorder) Counselor in Independence, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2019
Specialties on file
5

Practice location Address checks out

6200 Rockside Woods Blvd N Ste 305
Independence, OH 44131-2343
Phone: (234) 410-5775
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence CDCA.183151 (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X
Social Worker Taxonomy 104100000X · Licence S.2202740-TRNE (OH)
Peer Specialist Taxonomy 175T00000X (OH)

Record details

NPI number1083188643
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 17, 2019
Last updated in NPPESAugust 8, 2024
Certification dateAugust 8, 2024

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