Kelly Chisholm, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0103091 Issued in NM

Practice address

8500 Menaul Blvd NE Ste B455
Albuquerque, NM 87112-2287

Phone

(505) 974-0104

NPI assigned

May 1, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Emdr Therapy Solutions

  • Adult Mental Health Clinic/Center
  • Albuquerque, NM
  • NPI 1730816406
  NPD Authorized official
• Sedona Family Counseling

  • Adult Mental Health Clinic/Center
  • Sedona, AZ
  • NPI 1659936680
  NPD (past) Authorized official
• Springs Family Counseling

  • Professional Counselor
  • Colorado Springs, CO
  • NPI 1437661360

  Professional

  NPD (past) Authorized official
• Albuquerque Family Counseling

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1255148979

  Professional

  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1346461852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 MENAUL BLVD NE STE B455",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122287",
            "telephone_number": "505-974-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 MENAUL BLVD NE STE B455",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122287",
            "telephone_number": "505-974-0104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5527 N Union Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809186955",
            "country_code": "US",
            "telephone_number": "719-208-8650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "KELLY",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0103091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NM600403",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunflower Chirieleison, MPT
• Chiropractic Arts
• Chiropractic Lifestyle Center, P.C.
• Krystalena Chischilly, LSAA
• Douglas Paul Chisholm, DMD
• Haywan Chiu, DPM
• Mark T. Chiu, M.D.
• Toby Chiu, PHARMD
• Wilson Chiu, MD
• Stephen J Chiulli, PH.D.

• All providers in Albuquerque, NM
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.