| Doctor Name: | MR. GARY FRANK KELLY |
| NPI Number: | 1194930610 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.M.H.C. |
| License Number: | 002425-1 |
| Business Practice Address: | 8 Clarkson Ave Potsdam, NY - 136995825 |
| Business Phone Number: | 3152687105 |
| Business Fax Number: | |
| Mailing Address: | 288 Joe Indian Pond Road, PARISHVILLE |
| State: | NY |
| Postal Code: | 136722433 |
| Phone Number: | 3152652772 |
| Fax Number: | |
| NPI Enumeration Date: | 05/10/2007 |
| NPI Last Update Date: | 10/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 002425-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |