Active NPI
Kelly Allyn Sellers
- Professional Counselor
- Live Oak, TX
National Provider Identifier
1841910221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 88478
- Practice address
- 11901 Toepperwein Rd Ste 1202
Live Oak, TX 78233-3159 - Phone
- (210) 951-3479
- NPI assigned
- Aug 29, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 88478 | TX | Primary |
Addresses
Primary practice location
11901 Toepperwein Rd Ste 1202
Live Oak, TX 78233-3159
Mailing address
3738 Gallery WLS
San Antonio, TX 78261-2810
Phone (210) 381-8077
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 |
|---|---|---|---|
| 88478 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Usawa Wellness Services | Professional | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661731200000",
"number": "1841910221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3738 GALLERY WLS",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782612810",
"telephone_number": "210-381-8077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11901 TOEPPERWEIN RD STE 1202",
"city": "LIVE OAK",
"state": "TX",
"postal_code": "782333159",
"telephone_number": "210-951-3479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELLERS",
"first_name": "KELLY",
"middle_name": "ALLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-29",
"last_updated": "2022-08-29",
"certification_date": "2022-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "88478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Live Oak, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.