KELLY M TEDESCO LPC
NPI 1336874163
Counselor - Professional in Short Hills, NJ
About Kelly M Tedesco Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY M TEDESCO LPC (NPI 1336874163) is an individual professional provider in Short Hills, New Jersey, licensed in New Jersey (37PC00920600) and active in the NPI registry since July 2022. She has opted out of Medicare through March 17, 2027 and maintains a secondary practice location in Cranford.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Kelly M Tedesco Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 17, 2025 through March 17, 2027.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SHORT HILLS, NJ 07078
SHORT HILLS, NJ 07078
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Tedesco's NPI number?
The NPI number for Kelly Tedesco is 1336874163. It was assigned to this individual provider in the NPPES registry on July 17, 2022.
Where is Kelly Tedesco located?
Kelly Tedesco practices at 830 Morris Tpke Ste 405, Short Hills, NJ 07078. The listed phone number is (862) 206-6861.
What is Kelly Tedesco's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Kelly Tedesco enrolled in Medicare?
No. Kelly Tedesco has opted out of Medicare through March 17, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Kelly Tedesco was last updated on March 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kelly M Tedesco, LPC · NPI 1336874163
Professional provider in Short Hills, New Jersey. Individual provider, active in the CMS NPPES registry since July 17, 2022.
## Identity
- **NPI:** 1336874163 (Entity type: Individual)
- **Enumerated:** July 17, 2022
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 37PC00920600 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 830 MORRIS TPKE STE 405, Short Hills, NJ 07078-2620
- **Phone:** (862) 206-6861
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through March 17, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** March 9, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1336874163) · Data from the CMS NPPES public registry.