Kelsey Lynn Mora, CCLS, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.014683 Issued in IL

Practice address

400 Central Ave Ste 250
Northfield, IL 60093-3024

Phone

(402) 650-0656

NPI assigned

Oct 6, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Stephanie a Ross Licensed Clinical Psychologist PC

  • Clinical Psychologist
  • Glenview, IL
  • NPI 1760516660
  NPD (past)

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

{
    "created_epoch": "1538784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703894400000",
    "number": "1871068783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CENTRAL AVE STE 250",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933024",
            "telephone_number": "847-231-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CENTRAL AVE STE 250",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933024",
            "telephone_number": "402-650-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "KELSEY",
        "middle_name": "LYNN",
        "credential": "CCLS, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-06",
        "last_updated": "2023-12-30",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "21412",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.014683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Mokrzycka-Pys, D.C.
• Samuel Moltz, M.D.
• Mona H Berman Ma, LTD
• Carolina Montoya
• Justin Anthony Moore
• Camilo Morales Hormiga
• Kathryn Moreno
• Alexander Morrill, M.D.
• Angela Ak Muganwa
• Deandra Mugnolo, OT

• Mental Health Counselor in Northfield, IL
• Providers in Northfield, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2023; 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.