Provider Demographics
NPI:1003107806
Name:KELLY, MORGEN A R (PHD)
Entity Type:Individual
Prefix:DR
First Name:MORGEN
Middle Name:A R
Last Name:KELLY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 GREENTREE RD
Mailing Address - Street 2:BUILDING 3
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-3508
Mailing Address - Country:US
Mailing Address - Phone:412-822-2971
Mailing Address - Fax:
Practice Address - Street 1:VAPHS, UNIVERSITY DRIVE C
Practice Address - Street 2:STOP CODE: 122-G
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240
Practice Address - Country:US
Practice Address - Phone:412-822-2971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016792103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical