KELSEY MCNICHOLS (NPI# 1699306332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699306332 |
| Entity Type | Individual |
| Full Name | KELSEY MCNICHOLS |
| Credential | MHP |
| Practice Address |
206 W 5th St Metropolis IL 62960-1810 |
| Mailing Address |
6667 Powers Church Rd Metropolis IL 62960-6029 |
| Practice Telephone | 6185249368 |
| Mailing Telephone | 6186452028 |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ANY OTHER | 101Y00000X | 01 |
| IL | 101Y00000X | 05 |
| Street Address |
206 W 5TH ST |
| City | METROPOLIS |
| State | IL |
| Zip Code | 62960-1810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902419583 | Brittney Lynn Woods | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2020-08-25 |
| 1447863063 | Maribeth Dippie Ethridge-hicks | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2020-08-24 |
| 1093327322 | Jessica Weaver | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2020-08-18 |
| 1023636479 | Jennea Harris | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2020-07-13 |
| 1831725050 | Shantaye Powell | Social Worker | 206 W 5th St, Metropolis, IL 62960-1810 | 2020-03-19 |
| 1649827155 | Tina Michelle Mathis | Social Worker | 206 W 5th St, Metropolis, IL 62960-1810 | 2019-08-20 |
| 1376190884 | Lily Madison Holland | Social Worker | 206 W 5th St, Metropolis, IL 62960-1810 | 2019-08-20 |
| 1629530498 | Cicely Ronielle Shelton | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2019-04-02 |
| 1013471424 | Dylan Wade Street | Student in an Organized Health Care Education/Training Program | 206 W 5th St, Metropolis, IL 62960-1810 | 2019-01-30 |
| 1336603877 | Cynthia Lynn Dunevnt | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2019-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972069078 | Amber Nicole Garcia | Social Worker | 205 W 5th Street, Metropolis, IL 62960 | 2019-02-13 |
| 1407251622 | Massac County Surgery Center LLC | Clinic/Center | 1811 E 5th St, Metropolis, IL 62960 | 2014-10-30 |
| 1750535761 | Robert Hays Bryan | Dentist | 805 Market St., Metropolis, IL 62960 | 2008-11-05 |
| 1518144682 | Rebecca Louise Mcquage | Counselor | 206 West 5th St, Metropolis, IL 62960 | 2008-01-30 |
| 1154640902 | Syed S Kazmi | Family Medicine | 12 Hospital Drive, Metropolis, IL 62960 | 2007-04-20 |
| 1083736680 | Bharat K Patel Sc | Internal Medicine | 12 Hospital Dr., Memorial Heights, Metropolis, IL 62960 | 2007-04-04 |
| 1467594747 | Peggy Sue Legereit | Speech-Language Pathologist | 3037 Lakeview Dr, Metropolis, IL 62960 | 2007-02-13 |
| 1821150475 | Ruth E Johnson | Counselor | 206 West 5th, Metropolis, IL 62960 | 2006-12-13 |
| 1720140379 | James Allen Haley | Counselor | 206 West 5th Street, Metropolis, IL 62960 | 2006-12-13 |
| 1659432185 | Gary T Brush | Optometrist | 1801 E 5th Street, Metropolis, IL 62960 | 2006-12-12 |
| Find all providers in zip 62960 | ||||
| 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 |
|---|---|---|---|---|
| 1689171464 | Rodney Eugene Mayberry | Counselor | 306 W 8th St Apt D, Metropolis, IL 62960-1656 | 2018-04-09 |
| 1518144682 | Rebecca Louise Mcquage | Counselor | 206 West 5th St, Metropolis, IL 62960 | 2008-01-30 |
| 1821150475 | Ruth E Johnson | Counselor | 206 West 5th, Metropolis, IL 62960 | 2006-12-13 |
| 1720140379 | James Allen Haley | Counselor | 206 West 5th Street, Metropolis, IL 62960 | 2006-12-13 |
| 1902419583 | Brittney Lynn Woods | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2020-08-25 |
| 1093327322 | Jessica Weaver | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2020-08-18 |
| 1023636479 | Jennea Harris | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2020-07-13 |
| 1629530498 | Cicely Ronielle Shelton | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2019-04-02 |
| 1336603877 | Cynthia Lynn Dunevnt | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2019-01-29 |
| 1386111565 | Stephanie B Looper | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2018-10-25 |
| Find all providers in METROPOLIS | ||||
| City | METROPOLIS |
| Zip Code | 62960 |
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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.