Individual provider Active NPI

Kyann Kersey

  • Addiction (Substance Use Disorder) Counselor
  • Circleville, OH
National Provider Identifier
1659021400
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.183843 Issued in OH
Practice address
906 N Court St Ste B
Circleville, OH 43113-1281
Phone
(614) 776-4646
NPI assigned
Mar 25, 2022
Last updated
Nov 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.183843 OH Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

906 N Court St Ste B
Circleville, OH 43113-1281

Mailing address

5925 Cleveland Ave
Columbus, OH 43231-2208

Other practice location 1

1660 W Market St
Tiffin, OH 44883-2536
Phone (614) 776-4646

Other practice location 2

5925 Cleveland Ave
Columbus, OH 43231-2208
Phone (614) 776-4646

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
CDCA.183843OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Highlife Recovery, LLC Current Accepting new patients
Highlife Recovery, LLC Current Accepting new patients

Locations

906 N Court St
Ste B
Circleville, OH 43113
Phone (614) 776-4646

906 N Court St
Ste C
Circleville, OH 43113
Phone (614) 776-4646

1660 W Market St
Tiffin, OH 44883
Phone (614) 776-4646

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1659021400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 CLEVELAND AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432312208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 N COURT ST STE B",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431131281",
            "telephone_number": "614-776-4646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 W Market St",
            "address_purpose": "LOCATION",
            "city": "Tiffin",
            "state": "OH",
            "postal_code": "448832536",
            "country_code": "US",
            "telephone_number": "614-776-4646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5925 Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432312208",
            "country_code": "US",
            "telephone_number": "614-776-4646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERSEY",
        "first_name": "KYANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.183843",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Circleville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.