Individual provider Active NPI

Kelly Bishop, LCPC, LPC

  • Mental Health Counselor
  • Ellicott City, MD
National Provider Identifier
1568044782
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC13457 Issued in MD
Practice address
8181 Main Street
2ND Floor
Ellicott City, MD 21043
Phone
(757) 651-3001
Fax
(757) 222-3833
NPI assigned
Apr 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LC13457 MD Primary
Mental Health Counselor 101YM0800X PC015753P PA

Addresses

Primary practice location

8181 Main Street
2ND Floor
Ellicott City, MD 21043

Mailing address

5010 Ritter Rd Ste 109
Mechanicsburg, PA 17055-4828
Phone (717) 357-8230

Other practice location 1

5010 Ritter Rd Ste 109
Mechanicsburg, PA 17055-4828
Phone (717) 357-8230

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
LC13457MDMDMental Health Counselor
PC015753PPAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Evolutionary Soul Counseling & Wellness Services, LLC CurrentSince Dec 3, 2023 Accepting new patients
Village Counseling LLC CurrentSince May 16, 2021 Accepting new patients
KB Counseling, LLC Current Accepting new patients

Locations

5010 Ritter Rd
Ste 109
Mechanicsburg, PA 17055
Phone (717) 357-8230

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1568044782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 RITTER RD STE 109",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554828",
            "telephone_number": "717-357-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8181 MAIN STREET",
            "address_2": "2ND FLOOR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21043",
            "telephone_number": "757-651-3001",
            "fax_number": "757-222-3833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5010 Ritter Rd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Mechanicsburg",
            "state": "PA",
            "postal_code": "170554828",
            "country_code": "US",
            "telephone_number": "717-357-8230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "KELLY",
        "credential": "LCPC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-27",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC13457",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC015753P",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.