Individual provider Active NPI

Kamala Jean Kelton, LCMHC

  • Mental Health Counselor
  • Waterbury, VT
National Provider Identifier
1649218439
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
068-0000359 Issued in VT
Practice address
55 S Main St
Box 4
Waterbury, VT 05676-1556
Phone
(802) 244-7937
Fax
(802) 244-7937
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 068-0000359 VT Primary

Addresses

Primary practice location

55 S Main St
Box 4
Waterbury, VT 05676-1556

Mailing address

55 S Main St
Box 4
Waterbury, VT 05676-1556
Phone (802) 244-7937

Other identifiers 1

IdentifierTypeStateIssuer
1007352MedicaidVT

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
068-0000359VTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1649218439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 S MAIN ST",
            "address_2": "BOX 4",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "056761556",
            "telephone_number": "802-244-7937",
            "fax_number": "802-244-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 S MAIN ST",
            "address_2": "BOX 4",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "056761556",
            "telephone_number": "802-244-7937",
            "fax_number": "802-244-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELTON",
        "first_name": "KAMALA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068-0000359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007352",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, VT

Sources for this page

Verify at the official NPI Registry.