Active NPI
Kelly Leigh Flynn, MS, LPCA
- Professional Counselor
- Bend, OR
National Provider Identifier
1699516807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 504527
- Practice address
- 296 SW Columbia St Ste a
Bend, OR 97702-1020 - Phone
- (541) 633-4591
- Fax
- (541) 797-0106
- NPI assigned
- Jun 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 504527 | OR | Primary |
Addresses
Primary practice location
296 SW Columbia St Ste a
Bend, OR 97702-1020
Mailing address
1497 NW Saginaw Ave
Bend, OR 97703-1532
Phone (541) 390-2707
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 504527 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728345600000",
"number": "1699516807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1497 NW SAGINAW AVE",
"city": "BEND",
"state": "OR",
"postal_code": "977031532",
"telephone_number": "541-390-2707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "296 SW COLUMBIA ST STE A",
"city": "BEND",
"state": "OR",
"postal_code": "977021020",
"telephone_number": "541-633-4591",
"fax_number": "541-797-0106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYNN",
"first_name": "KELLY",
"middle_name": "LEIGH",
"credential": "MS, LPCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-03",
"last_updated": "2024-10-08",
"certification_date": "2024-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "504527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.