Kelly Poff

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

631 S 1St St
Dekalb, IL 60115-4117

Phone

(815) 756-8501

NPI assigned

Nov 12, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1053913293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1109",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601157109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S 1ST ST",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601154117",
            "telephone_number": "815-756-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POFF",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-12",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelin Pippel, MA, LCPC
• William A Pitney III, ATC
• Heidi Pittsley
• Rafael Suello Plenos III, APRN, CNP
• Elizabeth Pociask
• Jill Pohlman
• Allison Polz, LCSW
• Christine M Polz, APRN, CNP
• Justin Patrick Pomar, ATC, LAT
• Fidel Ponce, BA

• All providers in Dekalb, IL
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.