Individual provider Active NPI

Kelsey L Willson, LPCC

  • Professional Counselor
  • Frankfort, KY
National Provider Identifier
1104276922
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
241632 Issued in KY
Practice address
89 C Michael Davenport Blvd Ste 2
Frankfort, KY 40601-4481
Phone
(502) 875-0561
Fax
(502) 845-0570
NPI assigned
Jun 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 241632 KY Primary

Addresses

Primary practice location

89 C Michael Davenport Blvd Ste 2
Frankfort, KY 40601-4481

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240103001904 KY Practitioner - Mental Health Counselor 9133579196 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Family Medical Center Inc Current Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Jan 1, 2024 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Jan 1, 2024 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Oct 9, 2022 Accepting new patients

Locations

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

383 Lancaster St
Crab Orchard, KY 40419
Phone (270) 858-6655

89 C Michael Davenport Blvd
Ste 2
Frankfort, KY 40601
Phone (502) 875-0561

285 Education Way
Stanford, KY 40484
Phone (606) 365-8400

Organizations & group practices 4

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": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1104276922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 C MICHAEL DAVENPORT BLVD STE 2",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406014481",
            "telephone_number": "502-875-0561",
            "fax_number": "502-845-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "KELSEY",
        "middle_name": "L",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "241632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, KY

Sources for this page

Verify at the official NPI Registry.