Kelley Rieder Klungland, LPC-MHSP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5357 Issued in TN

Practice address

1401 Williams St Ste 210
Chattanooga, TN 37408-1190

Phone

(423) 207-4712

NPI assigned

Jan 10, 2017

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

Other names 1

• Kelley Nicole Rieder Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Omni Community Health, Inc.

  • Community/Behavioral Health Agency
  • Knoxville, TN
  • NPI 1881024172

  Professional, TN

  Medicare reassignment NPD

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1477099828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 CHESTNUT ST APT 241",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374024521",
            "telephone_number": "931-247-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 WILLIAMS ST STE 210",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374081190",
            "telephone_number": "423-207-4712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUNGLAND",
        "first_name": "KELLEY",
        "middle_name": "RIEDER",
        "credential": "LPC-MHSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-10",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "5357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "RIEDER",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rebecca Klein, DC
• Julanne (Julie) Marie Kline, MS, LMFT
• Paige Ashley Klingborg, MD
• Christina Bailey Klouda
• Alison Kluk, MED
• Lashonda Chenelle Knaff
• Nathan Knappier
• Mairin Connor Knauss
• KND Development 59 LLC
• Aaron Lee Knight

• All providers in Chattanooga, TN
• Professional Counselor in Tennessee

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