Individual provider Active NPI

Kayla Ashlee McKissick, M.A.

  • Counselor
  • Kingsport, TN
National Provider Identifier
1942622550
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
455 W Sullivan St Apt 220
Kingsport, TN 37660-3670
Phone
(931) 265-2468
NPI assigned
Jan 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 007734 NY
Counselor 101Y00000X 4352 TN
Counselor 101Y00000X Primary

Addresses

Primary practice location

455 W Sullivan St Apt 220
Kingsport, TN 37660-3670

Mailing address

1106 W Sullivan St
Kingsport, TN 37660-3133
Phone (931) 265-2468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NY2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250423002862 TN Practitioner - Mental Health Counselor 4385169275 Reassigns benefits to 1 organization
I20250520004507 NY Practitioner - Mental Health Counselor 4385169275 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4352TNMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA CurrentSince Apr 1, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

40 Burton Hills Blvd
Ste 200
Nashville, TN 37215
Phone (615) 257-8410

Organizations & group practices 1

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": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1942622550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 W SULLIVAN ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603133",
            "telephone_number": "931-265-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 W SULLIVAN ST APT 220",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603670",
            "telephone_number": "931-265-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKISSICK",
        "first_name": "KAYLA",
        "middle_name": "ASHLEE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-16",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "007734",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": "4352",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.