Individual provider Active NPI

Kellie Rice, PSY. D., LCPC, CGP

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1891002242
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.007294 Issued in IL
Practice address
30 N Michigan Ave Ste 424
Chicago, IL 60602-3844
Phone
(312) 279-9981
Fax
(312) 279-9981
NPI assigned
Sep 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 180007294 IL
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 180.007294 IL Primary
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X 180007294 IL

Addresses

Primary practice location

30 N Michigan Ave Ste 424
Chicago, IL 60602-3844

Mailing address

3209 N Lakewood Ave
Chicago, IL 60657-3215
Phone (312) 279-9981

Other practice location 1

3209 N Lakewood Ave
Chicago, IL 60657-3215
Phone (872) 274-4344

Other identifiers 1

IdentifierTypeStateIssuer
180007294OtherILLCPC

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address MINDBODYCOOP.KELLIERICE@147350.advancedmd-direct.com Health Information Exchange (HIE)
Direct Messaging Address MINDBODYCOOP.KELLIERICE@147350.advancedmd-direct.com Health Information Exchange (HIE) Mind Body Co-op

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

LicenseStateTypeSpecialty
180.007294ILMDProfessional Counselor
180007294ILMDGroup Psychotherapy Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Body Co-Op Professional CurrentSince Oct 1, 2022 Accepting new patients
Mind Body Co-Op Addiction (Substance Use Disorder) CurrentSince Feb 7, 2021 Accepting new patients

Locations

3209 N Lakewood Ave
Chicago, IL 60657
Phone (312) 279-9981

30 N Michigan Ave
Ste 424
Chicago, IL 60602
Phone (312) 279-9981

Interoperability endpoints

  • Direct secure messaging: mindbodycoop.kellierice@147350.advancedmd-direct.com

Organizations & group practices 2

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": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1891002242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 N LAKEWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573215",
            "telephone_number": "312-279-9981",
            "fax_number": "866-671-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 424",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023844",
            "telephone_number": "312-279-9981",
            "fax_number": "312-279-9981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3209 N Lakewood Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606573215",
            "country_code": "US",
            "telephone_number": "872-274-4344",
            "fax_number": "866-671-9991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICE",
        "first_name": "KELLIE",
        "name_prefix": "Ms.",
        "credential": "PSY. D., LCPC, CGP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "180007294",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.007294",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "IL",
            "license": "180007294",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCPC",
            "identifier": "180007294",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MINDBODYCOOP.KELLIERICE@147350.advancedmd-direct.com",
            "affiliation": "N",
            "endpointDescription": "AMD HIE address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "30 N Michigan Ave Ste 424",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606023844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MINDBODYCOOP.KELLIERICE@147350.advancedmd-direct.com",
            "affiliation": "Y",
            "endpointDescription": "AMd",
            "affiliationName": "Mind Body Co-op",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "30 N Michigan Ave Ste 424",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606023844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.