Kelcy S Short, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180007089 Issued in IL

Practice address

3225 Hedley Rd
Springfield, IL 62711-6248

Phone

(217) 788-4065

Fax

(217) 788-4147

NPI assigned

Jan 29, 2009

Sex

Female

Sole proprietor

No

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

Enrolled in IL

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mental Health Centers of Central IllinoisGroup PAC ID 8325940521, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelcyshort@memorial.allscriptsdirect.net
• Direct secure messaging: kelcyshort@sfc.allscriptsdirect.net

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.

• Mental Health Centers of Central Illinois

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, IL
  • NPI 1225008113
  Medicare reassignment Care Compare group NPD
• Memorial Health Partners

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1376034744
  NPD
• Mental Health Centers of Central Illinois

  • Clinical Social Worker
  • Springfield, IL
  • NPI 1750614798

  Professional

  NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1346488319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N 8TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026324",
            "telephone_number": "217-525-1064",
            "fax_number": "217-525-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 HEDLEY RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116248",
            "telephone_number": "217-788-4065",
            "fax_number": "217-788-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "KELCY",
        "middle_name": "S",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180007089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kavya Shivaram, MD
• Jacob Bayley Sholl, PA-C
• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co. LLC
• Shopko Stores Operating Co. LLC
• Michael Short, PHARM.D., BCPS
• Stephanie Short, MD
• John Andrew Shoudel, DPM
• Jonathan Shpigelman
• Santosh Shrestha, M.D.

• Professional Counselor in Springfield, IL
• Providers in Springfield, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.