Individual provider Active NPI

Kelly Lea Nelson

  • Counselor
  • Elkhorn, NE
National Provider Identifier
1366308793
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
4663 N 209TH St
Elkhorn, NE 68022-5190
Phone
(402) 720-0595
NPI assigned
Dec 30, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NE Primary

Addresses

Primary practice location

4663 N 209TH St
Elkhorn, NE 68022-5190

Mailing address

4663 N 209TH St
Elkhorn, NE 68022-5190
Phone (402) 720-0595

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

NPI Registry JSON

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

{
    "created_epoch": "1767052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1366308793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4663 N 209TH ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680225190",
            "telephone_number": "402-720-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4663 N 209TH ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680225190",
            "telephone_number": "402-720-0595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KELLY",
        "middle_name": "LEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-30",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.