Active NPI
Kelsey L Collis
- Mental Health Counselor
- West Springfield, MA
National Provider Identifier
1699308338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1111 Elm St Ste 32E
West Springfield, MA 01089-1500 - Phone
- (413) 734-0300
- NPI assigned
- Feb 21, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1111 Elm St Ste 32E
West Springfield, MA 01089-1500
Mailing address
1111 Elm St Ste 32E
West Springfield, MA 01089-1500
Phone (413) 734-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110026265E | Medicaid | MA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582243200000",
"number": "1699308338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 ELM ST STE 32E",
"city": "WEST SPRINGFIELD",
"state": "MA",
"postal_code": "010891500",
"telephone_number": "413-734-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 ELM ST STE 32E",
"city": "WEST SPRINGFIELD",
"state": "MA",
"postal_code": "010891500",
"telephone_number": "413-734-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLIS",
"first_name": "KELSEY",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-21",
"last_updated": "2020-02-21",
"certification_date": "2020-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110026265E",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.