IndividualActive
Timothy Kelly, MA, LCPC
NPI 1720746308 · Counselor · East Saint Louis, IL
Provider details
- NPI number
- 1720746308
- Entity type
- Individual
- Primary specialty
- CounselorBehavioral Health & Social Service Providers
- Credential
- MA, LCPC
- Sex
- Male
- Sole proprietor
- No
- License
- 180013984 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
9400 Lebanon Rd
East Saint Louis, IL 62203-2214
Phone: (618) 397-0968
Street-level locationGet directions
Mailing address
9400 Lebanon Rd
East Saint Louis, IL 62203-2214
Registry dates
- Enumerated
- 2021-12-01
- Last updated
- 2021-12-01
- Certified
- 2021-11-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.