Active NPI
Kellyn Glynn, LPC
- Professional Counselor
- Breckenridge, CO
National Provider Identifier
1780956623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6350
- Practice address
- 106 N French St
Suite 201-1
Breckenridge, CO 80424 - Phone
- (720) 722-1242
- NPI assigned
- Feb 8, 2012
- 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 | 6350 | CO | Primary |
Addresses
Primary practice location
106 N French St
Suite 201-1
Breckenridge, CO 80424
Mailing address
PO Box 924
Breckenridge, CO 80424-0924
Phone (720) 722-1241
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6350 | CO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382486400000",
"number": "1780956623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 924",
"city": "BRECKENRIDGE",
"state": "CO",
"postal_code": "804240924",
"telephone_number": "720-722-1241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 N FRENCH ST",
"address_2": "SUITE 201-1",
"city": "BRECKENRIDGE",
"state": "CO",
"postal_code": "80424",
"telephone_number": "720-722-1242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLYNN",
"first_name": "KELLYN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-08",
"last_updated": "2013-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "6350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Breckenridge, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.