Laura Ann Kellicut, PHD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401014206 Issued in MI

Practice address

8424 Oakside St
Portage, MI 49002-5712

Phone

(269) 779-9518

NPI assigned

Oct 24, 2006

Last updated

Oct 7, 2026By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1922181601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8424 OAKSIDE ST",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490025712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 OAKSIDE ST",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490025712",
            "telephone_number": "269-779-9518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLICUT",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401014206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Carla Jean Kelly, LPC, LLPC
• Kevin James Kelly, MD
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• Kennedy Consultation & Wellness

• Mental Health Counselor in Portage, MI
• Providers in Portage, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; 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.