Active NPI
Mikel Kelly, MA, LMHC
- Mental Health Counselor
- Brownsburg, IN
National Provider Identifier
1295100600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39002195A
- Practice address
- 1650 Grassland Dr
Brownsburg, IN 46112-7893 - Phone
- (317) 946-3495
- NPI assigned
- Dec 10, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | 39002195A | IN | Primary |
Addresses
Primary practice location
1650 Grassland Dr
Brownsburg, IN 46112-7893
Mailing address
1650 Grassland Dr
Brownsburg, IN 46112-7893
Phone (317) 946-3495
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39002195A | IN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counselworx | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Brownsburg, IN
- NPI 1255705406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449705600000",
"number": "1295100600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 GRASSLAND DR",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461127893",
"telephone_number": "317-946-3495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 GRASSLAND DR",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461127893",
"telephone_number": "317-946-3495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MIKEL",
"name_prefix": "Mr.",
"credential": "MA, LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-10",
"last_updated": "2015-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39002195A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brownsburg, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.