Kevin Kelley, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C5590 Issued in OR

Practice address

921 Country Club Rd Ste 100
Eugene, OR 97401-6039

Phone

(541) 510-5071

NPI assigned

Jan 15, 2018

Sex

Male

Sole proprietor

No

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

Enrolled in OR

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• McKenzie Mental Health, LLC

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1750102075
  Medicare reassignment NPD Authorized official
• Christians As Family Advocates

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1548474562
  Medicare reassignment NPD

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

{
    "created_epoch": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1700394558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 COUNTRY CLUB RD STE 100",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016039",
            "telephone_number": "541-510-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 COUNTRY CLUB RD STE 100",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016039",
            "telephone_number": "541-510-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KEVIN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-15",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail Linda Keller, LCSW
• Paul Andrew Keller, P.T.
• Samantha Keller, LPN
• Susan M. Keller, LPC, M.S. ED.
• Chrystal Selene Kellerman
• Michael Frank Kelley, D.D.S.
• Nathan Kelley
• Kellie Kreitzberg, LCSW LLC
• Shannon Lee Kellow
• Nathan Kelly

• Mental Health Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.