Kelsey E. Tiernon, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3478 Stellhorn Rd
Fort Wayne, IN 46815-4630

Phone

(260) 452-5336

Fax

(260) 387-5075

NPI assigned

Aug 29, 2017

Sex

Female

Sole proprietor

Yes

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

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Grit and Grace Counseling LLC

  • Mental Health Counselor
  • Fort Wayne, IN
  • NPI 1871244657
  Medicare reassignment Authorized official
• Danny Anderson Counseling Services LLC

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1194435388

  Mental Health

  NPD

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1952828014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 BEINEKE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468081627",
            "telephone_number": "260-310-3266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3478 STELLHORN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154630",
            "telephone_number": "260-452-5336",
            "fax_number": "260-387-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNON",
        "first_name": "KELSEY",
        "middle_name": "E.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2021-11-10",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonya Tichler, PTA
• Stewart Gregory Tidwell, MA, LMHC
• Jonathan Alvin Tiedeman, SCHOOL PSYCHOLOGIST
• Susan Marie Tielker-Sharpe, LCSW LMFT ACSW
• Richard Elmer Tielker, M.D.
• Paige Tiernon
• Ian Tiffany, RBT
• Trisha Rose Tiffany, LPN
• Ryan Shane Tighe
• Kayla Tigner

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.