Individual provider Active NPI

Kelsey Okolowitcz, MA, LMHC

  • Mental Health Counselor
  • Pawtucket, RI
National Provider Identifier
1083018642
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
39 East Ave
Pawtucket, RI 02860-4003
Phone
(401) 312-9843
NPI assigned
Oct 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

39 East Ave
Pawtucket, RI 02860-4003

Mailing address

4 Rossi Dr
North Providence, RI 02904-5652
Phone (508) 889-1520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240201002584 MA Practitioner - Mental Health Counselor 1254784630 Reassigns benefits to 1 organization
I20260326002141 RI Practitioner - Mental Health Counselor 1254784630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

39 E Ave
Pawtucket, RI 02860-4003

4 Rossi Dr
North Providence, RI 02904-5652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

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": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1083018642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ROSSI DR",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029045652",
            "telephone_number": "508-889-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 EAST AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604003",
            "telephone_number": "401-312-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOLOWITCZ",
        "first_name": "KELSEY",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.