Kelsey M Dagenais, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180010357 Issued in IL

Practice address

5912 El Morro LN
Oak Forest, IL 60452-1922

Phone

(708) 560-3069

NPI assigned

Jun 14, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kelsey M Conlin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• KMCD Counseling PLLC

  • Professional Counselor
  • Oak Forest, IL
  • NPI 1366211492
  NPD Authorized official

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1457701070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5912 EL MORRO LN",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604521922",
            "telephone_number": "708-560-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5912 EL MORRO LN",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604521922",
            "telephone_number": "708-560-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGENAIS",
        "first_name": "KELSEY",
        "middle_name": "M",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180010357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "CONLIN",
            "middle_name": "M",
            "credential": "LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mackenzie Coulter, CCC-SLP
• Covenant Enabling Residences of Illinois
• Covenant Enabling Residences of Illinois
• Cory Cunningham, PA-C
• Colleen Curran, M.S.
• Lauren Elizabeth Danzie, RN
• Nivedita J Dave, MD
• David Chang Lee MD LTD
• Kimberly Joy De Jong, MA, LPC
• Sheryl M Deboer

• Professional Counselor in Oak Forest, IL
• Providers in Oak Forest, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.