Active NPI
Kellsy Teresa Gallup, M.S., LPC
- Mental Health Counselor
- Jerome, ID
National Provider Identifier
1326923707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1571861
- Practice address
- 924 S Davis St
Jerome, ID 83338-3250 - Phone
- (208) 490-6788
- NPI assigned
- Aug 6, 2025
- 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 | 1571861 | ID | Primary |
Addresses
Primary practice location
924 S Davis St
Jerome, ID 83338-3250
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Other practice location 1
132 5th Ave W Ste 1
Jerome, ID 83338-1871
Phone (208) 814-9800
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1571861 | ID | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1326923707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "924 S DAVIS ST",
"city": "JEROME",
"state": "ID",
"postal_code": "833383250",
"telephone_number": "208-490-6788"
}
],
"practiceLocations": [
{
"address_1": "132 5th Ave W Ste 1",
"address_purpose": "LOCATION",
"city": "Jerome",
"state": "ID",
"postal_code": "833381871",
"country_code": "US",
"telephone_number": "208-814-9800",
"fax_number": "208-933-9648",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GALLUP",
"first_name": "KELLSY",
"middle_name": "TERESA",
"credential": "M.S., LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-06",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "1571861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jerome, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.