Individual provider Active NPI

Kelly Egilske

  • Mental Health Counselor
  • Salem, OR
National Provider Identifier
1437690401
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
821 Saginaw St S
Salem, OR 97302-4121
Phone
(503) 315-8646
NPI assigned
Mar 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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 Primary

Addresses

Primary practice location

821 Saginaw St S
Salem, OR 97302-4121

Mailing address

821 Saginaw St S
Salem, OR 97302-4121
Phone (503) 315-8646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20240111003391 OR Practitioner - Mental Health Counselor 8325499569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem Psychiatric Associates PCGroup PAC ID 6002702420, 24 clinicians

Practice addresses (Care Compare)

821 Saginaw St S
Salem, OR 97302-4121
Phone (503) 362-1999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Psychiatric Associates, P.C. Mental Health CurrentSince May 9, 2024 Accepting new patients

Locations

821 Saginaw St S
Salem, OR 97302
Phone (503) 362-1999

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1437690401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 SAGINAW ST S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024121",
            "telephone_number": "503-315-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 SAGINAW ST S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024121",
            "telephone_number": "503-315-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGILSKE",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.