Active NPI
Kristin Kelly, MS MHC
- Mental Health Counselor
- Rochester, NY
National Provider Identifier
1275820177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 835 W Main St
Rochester, NY 14611-2335 - Phone
- (585) 368-6550
- NPI assigned
- Jun 30, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
835 W Main St
Rochester, NY 14611-2335
Mailing address
835 W Main St
Rochester, NY 14611-2335
Phone (585) 368-6550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 12, 2024 through Mar 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18754 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309392000000",
"number": "1275820177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 W MAIN ST",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146112335",
"telephone_number": "585-368-6550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 W MAIN ST",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146112335",
"telephone_number": "585-368-6550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "KRISTIN",
"credential": "MS MHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-30",
"last_updated": "2011-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.