Jeannie N Kelso, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C7281 Issued in MS

Practice address

1059 Ridgewood PL
Jackson, MS 39211-2018

Phone

(601) 957-3211

Fax

(601) 957-9753

NPI assigned

Jan 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Jean N Kelso Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ridgewood Clinics PA

  • Mental Health Counselor
  • Jackson, MS
  • NPI 1023233749
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225183056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 SHERMAN AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112129",
            "telephone_number": "601-398-0989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 RIDGEWOOD PL",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112018",
            "telephone_number": "601-957-3211",
            "fax_number": "601-957-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSO",
        "first_name": "JEANNIE",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "C7281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "KELSO",
            "middle_name": "N",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Morgan Kelly, MD
• Ophelia Kelly, L.P.C.
• Peggy L Kelly
• Penny Kelly, APRN
• Shenika Sharee Kelly
• David Wayne Kelton, M.D.
• Kemet Health One LLC
• Ann Butler Kemp, MD
• Stephen F Kemp, MD
• Christyana Kency

• Mental Health Counselor in Jackson, MS
• Providers in Jackson, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.