Kelly Drye

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A2001012 Issued in AR

Practice address

2005 McLain St
Newport, AR 72112-3662

Phone

(870) 495-1990

Fax

(870) 495-1994

NPI assigned

May 25, 2017

Last updated

Apr 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Gordon Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Life Strategies Counseling, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Pocahontas, AR
  • NPI 1427656099
  NPD (past)
• Northeast Arkansas Community Mental Health Center Inc

  dba Mid-South Health Systems Inc

  • Family Medicine Physician
  • Blytheville, AR
  • NPI 1043885759
  NPD (past)

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1598293227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 FOREST HOME RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015320",
            "telephone_number": "866-972-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 MCLAIN ST",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721123662",
            "telephone_number": "870-495-1990",
            "fax_number": "870-495-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRYE",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A2001012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "GORDON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Diversicare Pinedale, LLC (Newport Healthcare and Rehabilitation Center)
• Doctors Health Group, Inc
• Jennifer L Dorris, APRN
• Brandy Douglas
• Shelia Dove
• Samantha Jo Dubach, BA, SLPA
• Guilford M Dudley, MD
• Retha S Dudley, NP
• Terri Dukes
• Katie Duncan

• Mental Health Counselor in Newport, AR
• Providers in Newport, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.