Individual provider Active NPI

Kelsey Oglesby, LCPC

  • Mental Health Counselor
  • Mount Pulaski, IL
National Provider Identifier
1740778927
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180012997 Issued in IL
Practice address
1807 600TH St
Mount Pulaski, IL 62548-6009
Phone
(217) 671-2377
NPI assigned
Apr 24, 2018
Last updated
Mar 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180012997 IL Primary

Addresses

Primary practice location

1807 600TH St
Mount Pulaski, IL 62548-6009

Mailing address

1807 600TH St
Mount Pulaski, IL 62548-6009
Phone (217) 671-2377

Other practice location 1

332 W Marion Ave
Forsyth, IL 62535-1018
Phone (217) 792-6194

Other identifiers 1

IdentifierTypeStateIssuer
180012997OtherILCLINICAL LICENSE

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

State licenses

LicenseStateTypeSpecialty
180012997ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Counseling PLLC Mental Health CurrentSince Sep 6, 2020 Accepting new patients
Kendrick Counseling, PLLC Past Accepting new patients
McNicholl Counseling, P.C. PastSince Jan 19, 2025 Accepting new patients

Locations

332 W Marion Ave
Forsyth, IL 62535
Phone (217) 792-6194

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1740778927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 600TH ST",
            "city": "MOUNT PULASKI",
            "state": "IL",
            "postal_code": "625486009",
            "telephone_number": "217-671-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 600TH ST",
            "city": "MOUNT PULASKI",
            "state": "IL",
            "postal_code": "625486009",
            "telephone_number": "217-671-2377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "332 W Marion Ave",
            "address_purpose": "LOCATION",
            "city": "Forsyth",
            "state": "IL",
            "postal_code": "625351018",
            "country_code": "US",
            "telephone_number": "217-792-6194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGLESBY",
        "first_name": "KELSEY",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180012997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL LICENSE",
            "identifier": "180012997",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pulaski, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.