Patrick K Kelley, CSAC,ICS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

16004 Issued in WI

Practice address

1321 N Main St
Viroqua, WI 54665-1156

Phone

(608) 637-7052

Fax

(608) 785-0002

NPI assigned

Feb 24, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

• Family & Children'S Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • La Crosse, WI
  • NPI 1821127424
  NPD (past)

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1245824804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 MAIN ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014200",
            "telephone_number": "608-785-0001",
            "fax_number": "608-785-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 N MAIN ST",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546651156",
            "telephone_number": "608-637-7052",
            "fax_number": "608-785-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "PATRICK",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "CSAC,ICS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-24",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Kane
• Martha Arwen Karlstad, M.D.
• Eileen Therese Karpfinger, DC
• Charles Kauffman
• Denise Kehoe, MBA, RPH
• Anna Killips, RD
• Briana Ann King, COTA
• Jennifer J Klar
• Jessica L Klein, PA-C
• Leeanne Marie Klum, D.D.S.

• Addiction (Substance Use Disorder) Counselor in Viroqua, WI
• Providers in Viroqua, 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 Feb 24, 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.