Kelley Havill, LMFT, LMHC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

35001502A Issued in IN

Practice address

3925 Hagan St
203
Bloomington, IN 47401

Phone

(812) 334-0001

Fax

(812) 334-0001

NPI assigned

Feb 6, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Marriage and Family Therapist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1710026372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 HAGAN ST",
            "address_2": "203",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018556",
            "telephone_number": "812-333-9895",
            "fax_number": "812-334-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 HAGAN ST",
            "address_2": "203",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "47401",
            "telephone_number": "812-334-0001",
            "fax_number": "812-334-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVILL",
        "first_name": "KELLEY",
        "name_prefix": "Mrs.",
        "credential": "LMFT, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001493A",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35001502A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darbi Haug
• Jennifer Marie Hauge, BS
• Stephanie Nicole Hautsch, PA-C
• Haven'S Holistic Healing LLC
• William T Havens, PA
• Emily Mikayla Hawkins, NP
• Emma Hawkins
• Jordan Hawkins, DPM
• Maranda Hawkins
• Ron Hawkins, O.D.

• Marriage & Family Therapist in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Marriage & Family Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.