Shelly Lynn Ketelhut, MSE, NCC, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15566-130 Issued in WI

Practice address

1936B Algoma Blvd
Oshkosh, WI 54901-2104

Phone

(920) 232-0208

Fax

(844) 270-4612

NPI assigned

Aug 19, 2008

Last updated

Oct 8, 2021By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Ketelhut Counseling LLC

  • Community/Behavioral Health Agency
  • Oshkosh, WI
  • NPI 1497166797
  Authorized official Same address or phone

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1184871378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936B ALGOMA BLVD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549012104",
            "telephone_number": "920-232-0208",
            "fax_number": "844-270-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936B ALGOMA BLVD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549012104",
            "telephone_number": "920-232-0208",
            "fax_number": "844-270-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETELHUT",
        "first_name": "SHELLY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MSE, NCC, CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4498-125",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15566-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew J Kemnitz, DPM
• Emily Kempf
• Stephen G Kennebeck, PA-C
• Tisha M Kennebeck, PA-C
• Ketelhut Counseling LLC
• Jennifer Kettenhoven, LCSW
• Isna Khan
• Mohamad Y Khatib, MD
• Richard L Kiefer, MD
• Suzanne M Kiefer, APNP

• Addiction (Substance Use Disorder) Counselor in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.