Individual provider Active NPI

Kelsey Southerland, LAC

  • Mental Health Counselor
  • Batesville, AR
National Provider Identifier
1386512655
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A2509007 Issued in AR
Practice address
2025 Reynolds St
Batesville, AR 72501-7432
Phone
(870) 464-3601
Fax
(888) 977-2956
NPI assigned
Oct 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A2509007 AR Primary

Addresses

Primary practice location

2025 Reynolds St
Batesville, AR 72501-7432

Mailing address

1707 Linwood Dr Ste B
Paragould, AR 72450-5365
Phone (870) 604-4455

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
A2509007ARMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1761609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1386512655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 LINWOOD DR STE B",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724505365",
            "telephone_number": "870-604-4455",
            "fax_number": "888-977-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 REYNOLDS ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017432",
            "telephone_number": "870-464-3601",
            "fax_number": "888-977-2956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERLAND",
        "first_name": "KELSEY",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A2509007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.