Mark Kelsch, LMSW

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LCSW-37136 Issued in ID

Practice address

2267 Teton PLZ
Idaho Falls, ID 83404-6486

Phone

(208) 522-0140

Fax

(208) 524-7335

NPI assigned

Apr 20, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Human Dynamics and Diagnostics LLCGroup PAC ID 1153644547, 10 clinicians

Practice addresses (Care Compare)

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.

• Human Dynamics and Diagnostics, LLC

  • Community/Behavioral Health Agency
  • Idaho Falls, ID
  • NPI 1346368198
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1497046718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2267 TETON PLZ",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046486",
            "telephone_number": "208-524-4953",
            "fax_number": "208-524-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2267 TETON PLZ",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046486",
            "telephone_number": "208-522-0140",
            "fax_number": "208-524-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSCH",
        "first_name": "MARK",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LCSW-37136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346368198",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cody J. Kelly, AAC
• Kimberly Sue Kelly
• Melissa Ilene Kelly, FNP
• Paulo Kelly, DO
• Trent Merrill Kelly, DDS
• Brent Sheldon Kennedy, DPT
• Kenneth E Krell MD PA
• Helen Kenney, P.A.
• Kent Cutforth DDS
• Derek Kent, MD

• Professional Counselor in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.