Active NPI
Kellie Marie Allison, MC, LPC
- Professional Counselor
- Mesa, AZ
National Provider Identifier
1376852327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-12817
- Practice address
- 2353 E Brown Rd
Mesa, AZ 85213-5225 - Phone
- (480) 213-6891
- NPI assigned
- Sep 24, 2010
- Last updated
- Sep 24, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-12817 | AZ | Primary |
Addresses
Primary practice location
2353 E Brown Rd
Mesa, AZ 85213-5225
Mailing address
2428 E Billings St
Mesa, AZ 85213-8412
Phone (480) 213-6891
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3104 E Camelback Rd
Suite 2937
Phoenix, AZ 85016-4502
Phone (415) 360-3348
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-12817 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brightside Medical, P.a. | Current | Accepting new patients |
Locations
3104 E Camelback Rd
Phoenix, AZ 85016
Phone (888) 888-9930
2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285286400000",
"number": "1376852327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2428 E BILLINGS ST",
"city": "MESA",
"state": "AZ",
"postal_code": "852138412",
"telephone_number": "480-213-6891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2353 E BROWN RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852135225",
"telephone_number": "480-213-6891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLISON",
"first_name": "KELLIE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-24",
"last_updated": "2010-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-12817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; 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.