Individual provider Active NPI

Heather England Kelley, M.A., PSYD.

  • Professional Counselor
  • Minot, ND
National Provider Identifier
1861716037
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
1015 S Broadway Ste 18
Minot, ND 58701-4667
Phone
(701) 857-8500
NPI assigned
Mar 17, 2010
Last updated
Oct 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X AZ Primary

Addresses

Primary practice location

1015 S Broadway Ste 18
Minot, ND 58701-4667

Mailing address

1015 S Broadway Ste 18
Minot, ND 58701-4667
Phone (701) 857-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180228003046 ND Practitioner - Clinical Psychologist 9335400696 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Central Human Service CenterGroup PAC ID 6305885013, 23 clinicians
Northwest Human Service CenterGroup PAC ID 4183683196, 12 clinicians

Practice addresses (Care Compare)

1015 S Broadway
Suite 18
Minot, ND 58701-4667
Phone (701) 857-8500

316 2ND Ave W
Williston, ND 58801-5218
Phone (701) 774-4600

PO Box
Suite 1266
Williston, ND 58802-1266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
550NDMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Badlands Behavioral Health Clinic CurrentSince May 25, 2019 Accepting new patients
North Central Behavioral Health Clinic CurrentSince Feb 12, 2018 Accepting new patients
Northwest Behavioral Health Clinic CurrentSince Feb 12, 2018 Accepting new patients
Badlands Behavioral Health Clinic Past Accepting new patients

Locations

600 E Boulevard Ave
Dept 325
Bismarck, ND 58505
Phone (701) 328-4644

1463 I94 Business Loop E
Dickinson, ND 58601
Phone (701) 227-7500

1015 S Broadway
Ste 18
Minot, ND 58701
Phone (701) 857-8500

316 2nd Ave W
Williston, ND 58801
Phone (701) 774-4600

Organizations & group practices 4

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": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1861716037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S BROADWAY STE 18",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014667",
            "telephone_number": "701-857-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S BROADWAY STE 18",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014667",
            "telephone_number": "701-857-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "HEATHER",
        "middle_name": "ENGLAND",
        "name_prefix": "Dr.",
        "credential": "M.A., PSYD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-17",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

Verify at the official NPI Registry.