Kelsey Suzanne Hofer, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.2102584-SUPV Issued in OH

Practice address

188 W Hebble Ave
Fairborn, OH 45324-4960

Phone

(937) 754-5911

NPI assigned

Nov 2, 2019

Last updated

Aug 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Group Home LLCGroup PAC ID 7911407903, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

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.

• Phoenix Group Home, LLC

  dba PATH Integrated Healthcare

  • Community/Behavioral Health Agency
  • Portsmouth, OH
  • NPI 1083146013
  Medicare reassignment Care Compare group NPD
• Phoenix Group Home, LLC

  dba Path Behavioral Health- SUD

  • Substance Abuse Rehabilitation Facility
  • Cincinnati, OH
  • NPI 1336654854
  NPD

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

{
    "created_epoch": "1572652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724457600000",
    "number": "1386288314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX #24341",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45424",
            "telephone_number": "937-216-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 W HEBBLE AVE",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453244960",
            "telephone_number": "937-754-5911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "990 Villa St",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "CA",
            "postal_code": "94041",
            "country_code": "US",
            "telephone_number": "937-216-8806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOFER",
        "first_name": "KELSEY",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-02",
        "last_updated": "2024-08-24",
        "certification_date": "2024-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": "PC011607",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2102584-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asia Hinton
• Carissa Marie Hite
• James Hite III
• Holly Hobbs
• Alize Zhane Hobdy
• Andrew Hoffman, PHARMD
• Jahnon Hogan
• Matthew D Holmes, MD
• Seth Holmquist
• Brooke Holycross

• Professional Counselor in Fairborn, OH
• Providers in Fairborn, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2024; 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.

Verify at the official NPI Registry.