Active NPI
Krista Delaney McKelvin, LPC
- Professional Counselor
- Dallas, TX
National Provider Identifier
1578636015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 81766
- Practice address
- 11551 Forest Central Dr Ste 202
Dallas, TX 75243-3919 - Phone
- (817) 751-7802
- Fax
- (847) 859-5885
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4103 | OK | |
| Professional Counselor | 101YP2500X | 81766 | TX | Primary |
Addresses
Primary practice location
11551 Forest Central Dr Ste 202
Dallas, TX 75243-3919
Mailing address
175 E Hawthorn Pkwy Ste 235
Vernon Hills, IL 60061-1454
Phone (847) 737-8768
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81766 | TX | MD | Professional Counselor |
| 4103 | OK | MD | Otolaryngology/Facial Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PHC of Buffalo Grove Clinical Psychology | Current | Accepting new patients | |
| Pinnacle Transformations | Current | Accepting new patients |
Locations
175 E Hawthorne Pkwy
Ste 235
Vernon Hills, IL 60061
Phone (847) 865-4125
11551 Forest Central Dr
Ste 202
Dallas, TX 75243
Phone (817) 751-7802
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Wichita Falls, TX
- NPI 1295527604
-
- Psychologist
- Vernon Hills, IL
- NPI 1235430612
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558656000000",
"number": "1578636015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 E HAWTHORN PKWY STE 235",
"city": "VERNON HILLS",
"state": "IL",
"postal_code": "600611454",
"telephone_number": "847-737-8768",
"fax_number": "847-859-5885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11551 FOREST CENTRAL DR STE 202",
"city": "DALLAS",
"state": "TX",
"postal_code": "752433919",
"telephone_number": "817-751-7802",
"fax_number": "847-859-5885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKELVIN",
"first_name": "KRISTA",
"middle_name": "DELANEY",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2019-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OK",
"license": "4103",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "81766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.