Kelly Altic Lisw-S Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KELLY ALTIC LISW-S COUNSELING LLC

Practice address

670 Meridian Way Ste 225
Westerville, OH 43082-2304

Phone

(614) 974-9808

NPI assigned

Apr 14, 2021

Organization subpart

No

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

Authorized official

Name

Kelly Altic, LISW-S

Title

Owner

Phone

(614) 974-9808

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Healthy Self Counseling Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1043891898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MERIDIAN WAY STE 225",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430822304",
            "telephone_number": "614-974-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 MERIDIAN WAY STE 225",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430822304",
            "telephone_number": "614-974-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY ALTIC LISW-S COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "ALTIC",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-974-9808",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0324160",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kellyaltic@counselingsecure.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "670 Meridian Way Ste 225",
            "city": "Westerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430822304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Healthy Self Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Keil
• Fatoumata Keita
• John Sheku Keita
• Vonda Keita
• Cynthia Josephine Kellar, CNP
• Caitlin T Kelly, OD
• Timothy Kelly, MD
• Erin Kathryn Kemp, D.D.S.
• Kathryn Mault Kemp, D.D.S
• William R Kemp, M.D.

• Clinical Social Worker in Westerville, OH
• Providers in Westerville, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.