Kelly Elaine Myers, LPC-MHSP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2360 Issued in TN

Practice address

192 Ozella LN
Clinton, TN 37716-6222

Phone

(865) 363-4189

NPI assigned

Oct 25, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1871210302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 OZELLA LN",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166222",
            "telephone_number": "865-363-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 OZELLA LN",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166222",
            "telephone_number": "865-363-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "KELLY",
        "middle_name": "ELAINE",
        "credential": "LPC-MHSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "2360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kellymyers@counselingmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "192 Ozella Ln",
            "city": "Clinton",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377166222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Casey J Montague, H.I.S.
• Bailey A Moore, COTA
• Jessica Moore, APRN
• Sharissa Rena Morris, LPN
• Ella J. Mowrer, M.S., R.D., LDN
• Thomas Russell Myers, DDS
• Elizabeth Anne Nelson
• Ellis Elizabeth Nelson, MSSW
• Daniel Burke Netwon, DDS
• New Purpose LLC

• Professional Counselor in Clinton, TN
• Providers in Clinton, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.