Kelly R. Elliott, M.ED., CMHS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

60325853 Issued in WA

Practice address

8378 W Grandridge Blvd Ste 110F
Kennewick, WA 99336-5402

Phone

(509) 392-5091

Fax

(509) 315-1295

NPI assigned

Dec 9, 2010

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1831492040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8378 W GRANDRIDGE BLVD STE 110F",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993365402",
            "telephone_number": "509-392-5091",
            "fax_number": "509-315-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8378 W GRANDRIDGE BLVD STE 110F",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993365402",
            "telephone_number": "509-392-5091",
            "fax_number": "509-315-1295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KELLY",
        "middle_name": "R.",
        "credential": "M.ED., CMHS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-09",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "60325853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.