Active NPI
Kelly Marie Elen, LMHC
- Mental Health Counselor
- Oswego, NY
National Provider Identifier
1306123104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 18P78740
- Practice address
- 56 W 3Rd St
Oswego, NY 13126-1522 - Phone
- (315) 342-6063
- NPI assigned
- Nov 8, 2011
- Sex
- Female
- 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 | 18P78740 | NY | Primary |
Addresses
Primary practice location
56 W 3Rd St
Oswego, NY 13126-1522
Mailing address
288 Woolson Rd
Oswego, NY 13126-6294
Phone (315) 342-6063
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18P78740 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386288000000",
"number": "1306123104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "288 WOOLSON RD",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131266294",
"telephone_number": "315-342-6063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 W 3RD ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131261522",
"telephone_number": "315-342-6063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELEN",
"first_name": "KELLY",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-08",
"last_updated": "2013-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "18P78740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oswego, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.