Kellie Rae Velasquez

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPCC.0018585 Issued in CO

Practice address

134 W Main St Ste 12
Trinidad, CO 81082-2600

Phone

(719) 859-2539

NPI assigned

Jun 19, 2021

Last updated

Jun 19, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CO

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

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• KRV Counseling LLC

  • Professional Counselor
  • Trinidad, CO
  • NPI 1821776204
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1624060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624060800000",
    "number": "1548839061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 DALE ST",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822006",
            "telephone_number": "719-242-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 W MAIN ST STE 12",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822600",
            "telephone_number": "719-859-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "KELLIE",
        "middle_name": "RAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-19",
        "last_updated": "2021-06-19",
        "certification_date": "2021-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0018585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trinidad Rehabilitation and Healthcare Center LLC
• Trinidad Reproductive Healthcare Inc
• Valerie J. Borsa MD
• Mary Ann Vecellio
• Michael Vecellio
• Victory Home Health, Palliative, Waiver Services, Inc,
• Vision Now Optics LLC (Vision Now Optics)
• Wal-Mart Stores, Inc. (Vision Center 30-0962)
• Walmart Inc. (Walmart Pharmacy 10-0962)
• Lisa Ward

• Mental Health Counselor in Trinidad, CO
• Providers in Trinidad, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2021; 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.