Katrina Kelley

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3062 E 91St St
Chicago, IL 60617-4401

Phone

(773) 371-2900

Fax

(773) 371-2950

NPI assigned

Jun 12, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Modern Insight Therapy PLLC

  • Professional Counselor
  • Chicago, IL
  • NPI 1215568480
  NPD Authorized official

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1356722565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17933",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606170933",
            "telephone_number": "312-618-7711",
            "fax_number": "773-371-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3062 E 91ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174401",
            "telephone_number": "773-371-2900",
            "fax_number": "773-371-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KATRINA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Kelley, MD
• Jatara Kelley
• Jordane Kelley
• Joseph Kelley
• Kathleen M. Kelley, M.D.
• Kent R Kelley, M.D.
• Kimberly Kelley, RN
• Kristin Sue Kelley, PT, DPT
• Mary Kate Kelley, PT
• Michael Kelley, PT

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.