Rachel C Kelly, LPC

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

License

04520 Issued in KS

Practice address

6221 Richards Dr
Shawnee, KS 66216-1724

Phone

(913) 248-1943

NPI assigned

Jun 6, 2024

Last updated

Jun 6, 2024By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Mirror, Inc.

  dba Mirror, Inc.

  • Substance Abuse Rehabilitation Facility
  • Newton, KS
  • NPI 1053431676
  NPD

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1376384917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E 5TH ST",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671142206",
            "telephone_number": "316-283-6743",
            "fax_number": "316-283-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 RICHARDS DR",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662161724",
            "telephone_number": "913-248-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "RACHEL",
        "middle_name": "C",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "04520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kcas, LLC (KCAS Clinical Laboratory)
• Martin Ryan Keegan, PHARM.D
• Donald Keeney III, PHARMD
• Marguerite Elizabeth Kelly-Salo, CRNA
• Megan Elizabeth Kelly, APRN, DNP, PMHNP-BC
• Stephanie L Kelly, RN
• Heather Kenworthy, LPN
• Katherine Elisabeth Kerner, APRN, FNP-C
• Nicole Kerr
• Brittany Kershaw

• Addiction (Substance Use Disorder) Psychologist in Shawnee, KS
• Providers in Shawnee, KS by specialty
• Addiction (Substance Use Disorder) Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.