Kellie T Boyle, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701006242 Issued in VA

Practice address

17336 Pickwick Dr Ste 101
Purcellville, VA 20132-6180

Phone

(804) 207-6737

NPI assigned

Aug 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kellie Doenges Tucker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: granatogroup.kellieboyle@144557.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Atlantic Behavioral Health Services, LLC

  • Mental Health Counselor
  • Leesburg, VA
  • NPI 1194394981
  NPD (past)
• Windward Optimal Health, LLC

  • Marriage & Family Therapist
  • Gainesville, VA
  • NPI 1093054397
  NPD (past)

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1407222078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17336 PICKWICK DR STE 101",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201326180",
            "telephone_number": "804-207-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17336 PICKWICK DR STE 101",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201326180",
            "telephone_number": "804-207-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "KELLIE",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701006242",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701006242",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "TUCKER",
            "middle_name": "DOENGES",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Blue Ridge Chiropractic & Acupuncture, LLC
• Rachel Blumberg, IBCLC
• Perri Lee Bonar, DPM
• Sydonie Bongam, DNP, PMHNP-BC, FNP-C
• Tessa Bowers, CFHC
• Alexa C Bradley
• Katie E. Brewer, PA-C
• Margaux Brown, PHD, LPC
• Karen Bruecken, LPC
• Jenna Marchitello Calo, DPT

• Professional Counselor in Purcellville, VA
• Providers in Purcellville, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.