Kellye Hutton Slaggert

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

9122 Issued in NC

Practice address

18047 W Catawba Ave Ste 203
Cornelius, NC 28031-5688

Phone

(704) 608-6812

Fax

(704) 696-7975

NPI assigned

Dec 6, 2012

Last updated

Apr 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 21, 2024 through Feb 21, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1043555725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 KINGS CROSS LN",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175906",
            "telephone_number": "704-608-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18047 W CATAWBA AVE STE 203",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315688",
            "telephone_number": "704-608-6812",
            "fax_number": "704-696-7975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9835 Northcross Center Ct Ste B",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787347",
            "country_code": "US",
            "telephone_number": "704-608-6812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLAGGERT",
        "first_name": "KELLYE",
        "middle_name": "HUTTON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-06",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "9122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA LPC",
            "identifier": "LPC911",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN BOARD OF PSYCHOLOGY",
            "identifier": "6301007938",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roy Kelley Sinclair, LPCA
• H'Exote Siu
• Michelle Rene Skaggs
• Laura Roel Skinner, PH.D.
• Daniel Derek Skotzko, D.D.S.
• Cember Lynn Slavens, BS
• Howard Ryan Slutzky, PSYD
• Donna Alicia Smith-Hogan, PH.D.
• Denette Smith
• Erica D Smith, FNP

• Mental Health Counselor in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.