Keely Kelly Hughes, QMHA, BS

Key facts

NPI

1629413448

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

Practice address

4455 NE Highway 20
Corvallis, OR 97330-9695

Phone

(541) 757-1852

NPI assigned

May 7, 2013

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Bachelor of Science

Specialties & licenses

Addresses

Other identifiers

Other names

• Kellon Donald Hughes Former name

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 22, 2019.

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1629413448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8770 SW SCOFFINS ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236226",
            "telephone_number": "503-684-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 NE HIGHWAY 20",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973309695",
            "telephone_number": "541-757-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "KEELY",
        "middle_name": "KELLY",
        "credential": "QMHA, BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629413448",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.lifeworksnw.org/",
            "affiliation": "N",
            "endpointDescription": "lifeworks",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8770 SW Scoffins St",
            "city": "Tigard",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972236226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLON",
            "last_name": "HUGHES",
            "middle_name": "DONALD",
            "credential": "QMHA, BS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corvallis, OR

• Sandra J Hufsmith, MD
• Angela M Hughes
• Dana K. Hughes, MPT, OCS
• Guy Hughes
• Hillary E Hughes, LCSW
• Robert Hughes, D.O.
• Sara Hughes
• Amy Hulan
• Hull Imaging LLC
• Dena M. Hulting, PA-C

All providers in Corvallis, OR · Mental Health Counselor in Oregon