Individual provider Active NPI

Kelly Renee Tilley, MA, LPCC-S, LMHC

  • Mental Health Counselor
  • Kent, OH
National Provider Identifier
1043391980
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.0003996-SUPV Issued in OH
Practice address
625 Loop Rd
Kent, OH 44242-9225
Phone
(330) 672-4287
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMHC10004142 MA
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X E.0003996-SUPV OH Primary

Addresses

Primary practice location

625 Loop Rd
Kent, OH 44242-9225

Mailing address

39066 Smith Rd
Litchfield, OH 44253-9603
Phone (440) 376-1842

Other practice location 1

151 Tremont St
Boston, MA 02111-1125
Phone (440) 376-1842

Other names 1

  • Kelly Renee Clapper Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LMHC10004142MAMDMental Health Counselor
E.0003996-SUPVOHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Transcend Therapeutic Services, LLC Professional CurrentSince Feb 9, 2025 Accepting new patients
State of Ohio Department of Mental Health Past Accepting new patients
State of Ohio Office of Budget and Management State Accounting Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1043391980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39066 SMITH RD",
            "city": "LITCHFIELD",
            "state": "OH",
            "postal_code": "442539603",
            "telephone_number": "440-376-1842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 LOOP RD",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442429225",
            "telephone_number": "330-672-4287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Tremont St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111125",
            "country_code": "US",
            "telephone_number": "440-376-1842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "KELLY",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPCC-S, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LMHC10004142",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0003996-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CLAPPER",
            "middle_name": "RENEE",
            "credential": "M.A., L.P.C.C., LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kent, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.