Individual provider Active NPI

Kelly Callen Magallon, MS

  • Mental Health Counselor
  • Grayslake, IL
National Provider Identifier
1205647849
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1190 E Washington St
Grayslake, IL 60030-7960
Phone
(847) 549-2235
NPI assigned
Jan 14, 2025
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

1190 E Washington St
Grayslake, IL 60030-7960

Mailing address

1705 North Ave
Waukegan, IL 60085-1950
Phone (224) 430-8501

Other names 1

  • Kelly Callen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of Grayslake LTD. CurrentSince Jan 19, 2025 Accepting new patients

Locations

1190 E Washington St
Grayslake, IL 60030
Phone (847) 477-0434

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1205647849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 NORTH AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600851950",
            "telephone_number": "224-430-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 E WASHINGTON ST",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600307960",
            "telephone_number": "847-549-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLEN MAGALLON",
        "first_name": "KELLY",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CALLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grayslake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.