KELLY CHISHOLM (NPI# 1245474873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245474873 |
| Entity Type | Individual |
| Full Name | KELLY CHISHOLM |
| Practice Address |
2402 Canyon Lake Dr Lubbock TX 79415-2000 |
| Practice Telephone | 8067625782 |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 33414 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346461852 | Kelly Chisholm | Counselor | 8500 Menaul Blvd Ne Ste B455, Albuquerque, NM 87112-2287 | 2007-05-01 |
| 1073978219 | Kelly M Chisholm | Pharmacist | 1585 Liberty Dr, Thomasville, NC 27360-6356 | 2015-12-15 |
| Street Address |
2402 CANYON LAKE DR |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79415-2000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174150684 | Children's Hope Residential Services, Inc. | Substance Abuse Rehabilitation Facility | 2402 Canyon Lake Dr, Lubbock, TX 79415-2000 | 2020-03-25 |
| 1477038974 | Trudy Joy Frye | Counselor | 2402 Canyon Lake Dr, Lubbock, TX 79415-2000 | 2018-10-01 |
| 1770079592 | Stephanie Cherie Powell | Counselor | 2402 Canyon Lake Dr, Lubbock, TX 79415-2000 | 2018-07-04 |
| 1447629597 | Don Julian Lenau | Counselor | 2402 Canyon Lake Dr, Lubbock, TX 79415-2000 | 2015-09-18 |
| 1902164684 | Children's Hope Residential Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2402 Canyon Lake Dr, Lubbock, TX 79415-2000 | 2012-05-01 |
| 1417263492 | Jodie Lynn Martin | Counselor | 2402 Canyon Lake Dr, Lubbock, TX 79415-2000 | 2010-08-27 |
| 1932333846 | Canyon Lakes Rtc | Counselor | 2402 Canyon Lake Dr, Lubbock, TX 79415-2000 | 2009-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831569540 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3502 9th St Ste 280, Lubbock, TX 79415 | 2015-10-07 |
| 1922447457 | Fnu Parijat Kumar | Physical Therapist | 2717 3rd Street, Aptt 803, Lubbock, TX 79415 | 2013-06-18 |
| 1851575906 | Diego Rivera, M.d., P.a. | Family Medicine | 111 University Ave, Lubbock, TX 79415 | 2007-12-26 |
| 1730206632 | Kathleen Brinkman Felts | Physical Therapist | 3710 4th Street, Lubbock, TX 79415 | 2007-03-23 |
| 1568508521 | Horace Rueben Sharp Jr. | Optometrist | 1911 4th St, Lubbock, TX 79415 | 2007-01-29 |
| 1699876201 | Patricia R. Arledge | Plastic Surgery | 3502 9th St., Suite 270, Lubbock, TX 79415 | 2006-09-26 |
| 1245330018 | Perlita Molina Sambrano-tandoc | Nurse Practitioner | 602 East Indiana Avenue, Lubbock, TX 79415 | 2006-09-22 |
| 1639199862 | Justin Tidwell | Emergency Medicine | 604 Indiana, Lubbock, TX 79415 | 2006-07-20 |
| 1912944059 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3301 Clovis Road, Lubbock, TX 79415 | 2006-05-31 |
| 1497709265 | Byron Wayne Schoettle | Radiology | 602 Indiana Avenue, Lubbock, TX 79415 | 2006-05-19 |
| Find all providers in zip 79415 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093314858 | Madison Bishop | Counselor | 7526 103rd St, Lubbock, TX 79424-6699 | 2020-10-22 |
| 1356948574 | Patricia May Johnson | Counselor | 4601 20th St, Lubbock, TX 79407-2307 | 2020-10-01 |
| 1023627304 | Denovo Therapy LLC | Counselor | 2345 50th St Ste 501, Lubbock, TX 79412-2565 | 2020-07-23 |
| 1770115677 | Melinda S. Hutcherson | Counselor | 4304 94th St, Lubbock, TX 79423-3958 | 2020-02-07 |
| 1336619790 | Jeong Han Kim | Counselor | 3601 4th St Stop 6225, Lubbock, TX 79430-6225 | 2018-11-28 |
| 1427531052 | Catholic Charities | Counselor | 102 Avenue J, Lubbock, TX 79401-1438 | 2018-09-10 |
| 1407380587 | Karmen Adkins Neal | Counselor | 2574 74th Street, Suite 213, Lubbock, TX 79423 | 2017-04-17 |
| 1225560071 | Kellye Wilhite | Counselor | 410 Ironton Ave, Lubbock, TX 79416-4102 | 2017-03-31 |
| 1972043545 | Angela Lee | Counselor | 2781 81st St, Lubbock, TX 79423-2229 | 2017-03-02 |
| 1003285321 | Gabrielle K Keenum Ma Lpc PC | Counselor | 6309 Indiana Ave Ste D, Lubbock, TX 79413-5739 | 2015-09-16 |
| Find all providers in LUBBOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.