Individual provider Active NPI

Kelly Renee Cassell, LPC

  • Professional Counselor
  • Wytheville, VA
National Provider Identifier
1255723912
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701006065 Issued in VA
Practice address
540 W Main St
Wytheville, VA 24382-2209
Phone
(276) 223-3291
Fax
(276) 223-3249
NPI assigned
Mar 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701006065 VA Primary

Addresses

Primary practice location

540 W Main St
Wytheville, VA 24382-2209

Mailing address

7054 W Blue Grass TRL
Ceres, VA 24318-3456
Phone (276) 613-1730

Other names 1

  • Kelly Renee Woliver Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20240215003169 VA Practitioner - Mental Health Counselor 5496199622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Rogers Community ServicesGroup PAC ID 1254387475, 33 clinicians

Practice addresses (Care Compare)

770 W Ridge Rd
Suite 220
Wytheville, VA 24382-1187
Phone 27622332003206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Rogers Community Services CurrentSince Jan 1, 2024 Accepting new patients

Locations

216 Hospital Ave
Marion, VA 24354
Phone (276) 783-8185

770 W Ridge Rd
Ste 220
Wytheville, VA 24382
Phone (276) 223-3200

770 W Ridge Rd
Wytheville, VA 24382
Phone (276) 223-3200

540 W Main St
Wytheville, VA 24382
Phone (276) 223-3206

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1255723912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7054 W BLUE GRASS TRL",
            "city": "CERES",
            "state": "VA",
            "postal_code": "243183456",
            "telephone_number": "276-613-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W MAIN ST",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243822209",
            "telephone_number": "276-223-3291",
            "fax_number": "276-223-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSELL",
        "first_name": "KELLY",
        "middle_name": "RENEE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-04",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701006065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WOLIVER",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wytheville, VA

Sources for this page

Verify at the official NPI Registry.