Individual provider Active NPI

Abbie Kelley

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1497021356
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.007700 Issued in IL
Practice address
2000 N Racine Ave
Suite 3300
Chicago, IL 60614-4045
Phone
(312) 485-3669
NPI assigned
Mar 26, 2012
Last updated
Nov 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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 180.007700 IL Primary

Addresses

Primary practice location

2000 N Racine Ave
Suite 3300
Chicago, IL 60614-4045

Mailing address

2000 N Racine Ave
Suite 3300
Chicago, IL 60614-4045
Phone (312) 485-3669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180.007700ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Abbie Kelley, LLC Mental Health CurrentSince Apr 25, 2021 Accepting new patients
Abbie Kelley, LLC Current Accepting new patients

Locations

2000 N Racine Ave
Ste 3300
Chicago, IL 60614
Phone (773) 413-9523

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1497021356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N RACINE AVE",
            "address_2": "SUITE 3300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144045",
            "telephone_number": "312-485-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N RACINE AVE",
            "address_2": "SUITE 3300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144045",
            "telephone_number": "312-485-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "ABBIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-26",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.007700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; 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.