Darby Kilkelly

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2962 Issued in MN

Practice address

815 37TH Ave S
Moorhead, MN 56560-5524

Phone

(701) 451-4811

Fax

(651) 925-0057

NPI assigned

Feb 28, 2023

Sex

Male

Sole proprietor

No

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

Enrolled in MN

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

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Village Family Service Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fargo, ND
  • NPI 1568492353

  MN

  Medicare reassignment NPD
• Village Family Service Center

  • Substance Abuse Rehabilitation Facility
  • Fargo, ND
  • NPI 1952679318
  NPD

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712448000000",
    "number": "1194424127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 12TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038753",
            "telephone_number": "701-451-4900",
            "fax_number": "651-925-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 37TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605524",
            "telephone_number": "701-451-4811",
            "fax_number": "651-925-0057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15710 Rockford Rd Apt 119",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554464213",
            "country_code": "US",
            "telephone_number": "651-472-6393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILKELLY",
        "first_name": "DARBY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-28",
        "last_updated": "2024-04-07",
        "certification_date": "2024-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Kelly
• Tennyson Kelm
• John Kennedy
• Abdikadir Kheir
• Kidscare Solution Inc
• McKenna Elizabeth Kilzer
• Von Karin King, PSY.D.
• Christian Kishlock, MD
• Danelle Klaman
• Danielle Klapper, LCAT, LPCC, ATR-BC

• Professional Counselor in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.