Individual provider Active NPI

Kelsey Dugan, LCPAT, LCAT, ATR-BC

  • Art Therapist
  • Frederick, MD
National Provider Identifier
1386036812
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Art TherapistTaxonomy code 221700000X
License
ATC310 Issued in MD
Practice address
5301 Buckeystown Pike Ste 360
Frederick, MD 21704-8360
Phone
(443) 846-0404
NPI assigned
Feb 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Art Therapist 221700000X 10205595 OR
Art Therapist 221700000X ATC310 MD Primary

Addresses

Primary practice location

5301 Buckeystown Pike Ste 360
Frederick, MD 21704-8360

Mailing address

709 Motter Ave
Frederick, MD 21701-4512
Phone (908) 963-9151

Other identifiers 2

IdentifierTypeStateIssuer
1386036812MedicaidOR
0023701MedicaidNJ

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

State licenses

LicenseStateTypeSpecialty
ATC310MDMDArt Therapist
10205595ORMDArt Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Psychological Health Services, LLC CurrentSince Nov 13, 2022 Accepting new patients

Locations

516 N Rolling Rd
Ste 201B
Catonsville, MD 21228
Phone (443) 478-3619

5301 Buckeystown Pike
Ste 360
Frederick, MD 21704
Phone (443) 671-8892

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": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1386036812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 MOTTER AVE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014512",
            "telephone_number": "908-963-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 BUCKEYSTOWN PIKE STE 360",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048360",
            "telephone_number": "443-846-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAN",
        "first_name": "KELSEY",
        "credential": "LCPAT, LCAT, ATR-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-20",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "OR",
            "license": "10205595",
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "MD",
            "license": "ATC310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386036812",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.