Kelly Kendricks

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

10694-125 Issued in WI

Practice address

2002 Atwood Ave Ste 225
Madison, WI 53704-5382

Phone

(608) 416-5245

Fax

(608) 416-5221

NPI assigned

Aug 19, 2020

Last updated

Nov 21, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

• Cornerstone Counseling Services, Inc

  dba LifeStance Health

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246
  Medicare reassignment NPD
• Insight Counseling & Wellness, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1447673702

  Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1548872765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S MARIETTA ST APT 101",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931816",
            "telephone_number": "608-609-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 ATWOOD AVE STE 225",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537045382",
            "telephone_number": "608-416-5245",
            "fax_number": "608-416-5221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 Atwood Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537045324",
            "country_code": "US",
            "telephone_number": "608-244-4859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENDRICKS",
        "first_name": "KELLY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-19",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "10694-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven J Kempton, M.D.
• Aria Kenarsary, MD
• Michelle L Kenas
• Cameron Richardson Kendall, M.D.
• Emerson Kendall, DO
• Alexander Kendziorski, MD
• Jordan Steel Kenik, M.D.
• Abdul Munem Kenj Halabi, MD
• Dima Kenj Halabi, MD
• Prabhav Kenkre, M.D.

• Professional Counselor in Madison, WI
• Providers in Madison, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; 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.