Kelly Marie Powell, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.012534 Issued in IL

Practice address

27W350 High Lake Rd
Winfield, IL 60190-1262

Phone

(630) 933-3033

NPI assigned

Oct 11, 2019

Last updated

Oct 11, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Wheaton Wellness Center, Inc.

  • Counselor
  • Wheaton, IL
  • NPI 1255807244
  NPD (past)

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1053953968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "0N126 BEVERLY ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601872547",
            "telephone_number": "630-890-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27W350 HIGH LAKE RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901262",
            "telephone_number": "630-933-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.012534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John P. Plante, M.D.
• Megan P Polson, FNP-BC
• Hana Madeleine Poser, MD
• Taylor Post, PHARMD
• Julie Potzick, M.D.
• John Gordon Prout, DO
• Sydney Pucel, AUD
• Mary Lynn Puchalski, DNP, APRN, CNS, NNP-
• Manfred James Pyka, MD
• Quality Therapy and Consultation

• Mental Health Counselor in Winfield, IL
• Providers in Winfield, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.