Kellie Medley, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11505 Issued in NC

Practice address

326 2ND Ave NW
Hickory, NC 28601-4944

Phone

(828) 328-4313

NPI assigned

May 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

State licenses

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.

• Gaston Family Health Services, Inc.

  dba Kintegra Family Medicine - Hudson

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1215932215
  Medicare reassignment NPD
• Gaston Family Health Services, Inc

  dba Kintegra Family Medicine - Xray Dr

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1306644315
  NPD
• Solutions of Hickory, PA

  • Clinical Psychologist
  • Hickory, NC
  • NPI 1780729129
  NPD (past)

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1992182596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 2ND AVE NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286014944",
            "telephone_number": "828-358-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 2ND AVE NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286014944",
            "telephone_number": "828-328-4313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Morganton Blvd SW",
            "address_purpose": "LOCATION",
            "city": "Lenoir",
            "state": "NC",
            "postal_code": "286455219",
            "country_code": "US",
            "telephone_number": "828-610-2742 x3310",
            "fax_number": "828-758-8633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "KELLIE",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-04",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NC",
            "license": "A11505",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "11505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Measured Dose Pharmacy Inc (The Compounding Pharmacy Infusion Services)
• Korsica Lassiter Mebane, MD
• Medical Center Pharmacy Inc of Hickory
• Medical Center Pharmacy Inc of Hickory
• Medical Services of America Inc (Medi Home Care)
• Haleigh Medlin, COTA/L, BT
• John Harvey Meier, M.D.
• Shaina Mae Melcher, LCSWA
• Megan S. Melendez, PA-C
• David Ethan Melon, M.D.

• Mental Health Counselor in Hickory, NC
• Providers in Hickory, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.