Kelsey Wonderlin

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5114 Issued in TN

Practice address

420B 37TH Ave N
Nashville, TN 37209-3730

Phone

(305) 304-4826

NPI assigned

Jul 14, 2020

Last updated

Aug 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kairos Mental Health Cooperative

  dba The Village of Kairos

  • Clinical Psychologist
  • Nashville, TN
  • NPI 1588138200

  Professional

  NPD (past)

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1891303020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420B 37TH AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372093730",
            "telephone_number": "305-304-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420B 37TH AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372093730",
            "telephone_number": "305-304-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONDERLIN",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "5114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC-MHSP",
            "identifier": "5114",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwonderlin@thevillageofkairos.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "1451 Elm Hill Pike Ste 250",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372104579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwonderlin@kelseywonderlin.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "420B 37th Ave N",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372093730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Women's Medical Associates II LLC
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• Womens Medical Associates of Nashville,PC
• Fay Yeh Womer, MD
• Amelia Wong, MD
• Benjamin William Chan Wong
• Melinda Wong, FNP-BC
• Nattawut Wongpraparut, M.D.
• Annalise C. Wood, R.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.