Kelly Marie Koelsch, RADT1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1447681021 Issued in CA

Practice address

2844 Coloma St
Placerville, CA 95667-4406

Phone

(530) 626-9240

NPI assigned

Oct 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: kelly.koelschradt.p1@direct.schc.nextgenshare.com

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1417611666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2844 COLOMA ST",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956674406",
            "telephone_number": "530-626-9240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2844 COLOMA ST",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956674406",
            "telephone_number": "530-626-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOELSCH",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "RADT1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1447681021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Knight
• Joshua J Knoblock
• Keenan Michael Knorr
• Patrick Michael Knost, M.D.
• William Koble, M.D.
• Christine Satomi Kondo-Lister, LCSW
• Andrei Ivanovich Kononovich, RN
• Ron L Kopitzke, P.T., DPT., OCS
• Jordyn Kotowski
• Toya Kuchena, NP

• Addiction (Substance Use Disorder) Counselor in Placerville, CA
• Providers in Placerville, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.