Kellye Jane Gist McKendree, M.A., L.P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3961 Issued in NC

Practice address

1021 Andersonwood Dr
Fuquay Varina, NC 27526-7976

Phone

(919) 417-1896

NPI assigned

Jan 18, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851444525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 ANDERSONWOOD DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275267976",
            "telephone_number": "919-417-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 ANDERSONWOOD DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275267976",
            "telephone_number": "919-417-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENDREE",
        "first_name": "KELLYE",
        "middle_name": "JANE GIST",
        "name_prefix": "Ms.",
        "credential": "M.A., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "3961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102920",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryden Sloan McCormick, D.D.S.
• Camille B McDaniel
• Shermonique McDonald
• Malaya McFadyen
• Sarah McGovern
• James Spain McKenzie, DDS PA
• Alexandria McKoy
• Erin McLamb, SLP
• Kasi Anne McLamb
• Keith Wayne McLaurin Jr., PHARMD

• Mental Health Counselor in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.