Kelli Jo Blair, B.S.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

Williamson Comprehensive Treatment Center Inc.
1609 West Third Avenue
Williamson, WV 25661

Phone

(304) 235-0026

NPI assigned

Sep 27, 2022

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 names 1

• Kelli Jo Kirk Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1942924741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 BIG LICK RD",
            "city": "INEZ",
            "state": "KY",
            "postal_code": "412248855",
            "telephone_number": "606-626-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WILLIAMSON COMPREHENSIVE TREATMENT CENTER INC.",
            "address_2": "1609 WEST THIRD AVENUE",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "25661",
            "telephone_number": "304-235-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "KELLI",
        "middle_name": "JO",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "KIRK",
            "middle_name": "JO",
            "credential": "B.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Brook Bishop, LPC
• Angela D Blackburn
• Larry Blackburn
• Georgennia Blackwell
• Barry J Blair
• Nichole Blair
• Deanna Kaylee Blankenship
• Katrina Blankenship, PRSS
• Lisa Marie Blankenship
• Tammy Blankenship

• Addiction (Substance Use Disorder) Counselor in Williamson, WV
• Providers in Williamson, WV by specialty
• Addiction (Substance Use Disorder) Counselor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.