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KELLY WALTHOUR
NPI 1710528161
Student in an Organized Health Care Education/Training Program in Coram, NY

Active since October 07, 2019
3600 ROUTE 112, CORAM, NY 11727(631) 920-8558 Get Directions Write a Review

NPPES record last updated: October 7, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly Walthour NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY WALTHOUR (NPI 1710528161) is an individual student in an organized health care education/training program in Coram, New York and active in the NPI registry since October 2019.

NPPES Registry Identity

NPI1710528161
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKELLY WALTHOUR
Location Address3600 ROUTE 112Coram, NY 11727-4116
Mailing Address3600 Route 112Coram, NY 11727-4116 · (631) 920-8558
Phone(631) 920-8558
Sole ProprietorNo
Enumeration DateOctober 7, 2019
✔ NPI 1710528161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3600 ROUTE 112, Coram, NY 11727
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAQUEL FERNANDES
Counselor (Mental Health)
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8500
ANNE KIRKHAM
Peer Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8500
JENNIFER HATFIELD
Student in an Organized Health Care Education/Training Program
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (630) 920-8500
TRAVIS J WINGATE
Day Training/Habilitation Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8520
JENNIFER WILLA SIEGFRIED
Social Worker
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8500
SHANNON TIERNEY
Counselor (Mental Health)
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8610
ROSE PRISCILLA SANCHEZ
Peer Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8302
NATHALY ESTRADA
Student in an Organized Health Care Education/Training Program
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8515

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 Walthour's NPI number?

The NPI number for Kelly Walthour is 1710528161. It was assigned to this individual provider in the NPPES registry on October 7, 2019.

Where is Kelly Walthour located?

Kelly Walthour practices at 3600 Route 112, Coram, NY 11727. The listed phone number is (631) 920-8558.

What is Kelly Walthour's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Kelly Walthour was last updated on October 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.