Individual provider Active NPI

Kelli Kohlstedt, ALMFT

  • Marriage & Family Therapist
  • Downers Grove, IL
National Provider Identifier
1972113793
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
208.000820 Issued in IL
Practice address
2901 Finley Rd Ste 101
Downers Grove, IL 60515-1394
Phone
(815) 469-1500
NPI assigned
Aug 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 208.000820 IL Primary

Addresses

Primary practice location

2901 Finley Rd Ste 101
Downers Grove, IL 60515-1394

Mailing address

2901 Finley Rd Ste 101
Downers Grove, IL 60515-1394
Phone (815) 469-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
208.000820ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. PastSince Jul 27, 2023 Accepting new patients
Edgewood Clinical Services, P.C. PastSince Aug 1, 2020 Accepting new patients

Organizations & group practices 2

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": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1972113793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 FINLEY RD STE 101",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151394",
            "telephone_number": "815-469-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 FINLEY RD STE 101",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151394",
            "telephone_number": "815-469-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLSTEDT",
        "first_name": "KELLI",
        "credential": "ALMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "208.000820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.