Kelsey Lynn Dennis Shave

Primary specialty

CounselorTaxonomy code 101Y00000X

License

180008381 Issued in IL

Practice address

404 N Hershey Rd Ste C
Bloomington, IL 61704-3560

Phone

(877) 381-6538

Fax

(312) 663-0504

NPI assigned

Sep 4, 2025

Last updated

Sep 4, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

• Gateway Foundation, Inc

  • Substance Abuse Rehabilitation Facility
  • Chicago, IL
  • NPI 1386779445

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1669352225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MONROE ST FL 18",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606613759",
            "telephone_number": "312-663-1130",
            "fax_number": "312-663-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N HERSHEY RD STE C",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043560",
            "telephone_number": "877-381-6538",
            "fax_number": "312-663-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS SHAVE",
        "first_name": "KELSEY",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "IL",
            "license": "180008381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer E Dena
• Allison Dawn Denehy, LCPC
• Destiny F Denning
• Dennis Lee MD LTD
• Dennis M Brtva (Dr Dennis M Brtva & Associates)
• Charles Dennis, M.D.
• Dental Professionals of Illinois, P.C. (Redbird Dental Care)
• Dental Professionals of Illinois, P.C. (Hershey Plaza Dental Care)
• Dental Professionals of Illinois, P.C. (Bloomington Smile Center)
• John Scott Denton, M.D.

• Counselor in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.