Kelsey Lynn Collins

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT112953 Issued in CA

Practice address

1621 Amberwood Dr Apt B
South Pasadena, CA 91030-1903

Phone

(951) 456-2287

NPI assigned

Dec 7, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 21, 2024 through Jan 21, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605916800000",
    "number": "1295279453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 AMBERWOOD DR APT B",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910301903",
            "telephone_number": "951-456-2287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 AMBERWOOD DR APT B",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910301903",
            "telephone_number": "951-456-2287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12021 Wilmington Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900593019",
            "country_code": "US",
            "telephone_number": "323-242-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "KELSEY",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2020-11-21",
        "certification_date": "2020-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT112953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Antoinette Ciliberti
• Cindy M Huang PHD Psychologist PC
• City of Hope Medical Foundation
• City of South Pasadena
• Juliana Lares Collaso
• Lacresha Elie Collins
• Victoria Combre
• Michael Commesso, PT, DPT
• Cynthia S Concepcion, MFT
• Connolly Counseling

• Marriage & Family Therapist in South Pasadena, CA
• Providers in South Pasadena, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.