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Active NPI 1659868941 Individual Practitioner Male Practitioner

Patrick C Kelley , LCDCIII, QMHS

Counselor • Coal Grove, OH

Professional Overview & Biography Verified Profile Summary

Patrick Kelley, LCDCIII, QMHS is a registered healthcare professional specializing in Counselor in Coal Grove, OH. Practice services are available at 225 CARLTON DAVIDSON LN under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

225 Carlton Davidson Ln

Coal Grove, OH 456382924

Telephone 7405330648
Fax 7403531662
Associated Practice Facility / Clinic
🏢 Shawnee Mental Health Center, Inc. Facility NPI 1225508195

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Coal Grove, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.0 Yrs
State Avg: 13.0 Yrs
Regional Practice Density
3 Specialists

Practicing in Coal Grove, OH (4163 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-09-05
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License OH C.2305166-TRNE

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.

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License OH LCDCIII.162407

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0361745 (OH)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Justin Triplett , LPN

Registered Nurse

NPI 1003274960

Licensed Practical Nurse

Rose Pollard , LSW

Social Worker - Clinical

NPI 1013264324

Licensed Social Worker

Kayla Kelley , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1013594332

Psychiatric-Mental Health Nurse Practitioner

Nathan Powell

Social Worker

NPI 1023520731
Stephanie Lang , NP-C

Nurse Practitioner - Psychiatric/Mental Health

NPI 1043782931

Nurse Practitioner (Certified)

Courtney Hayden

Case Manager/Care Coordinator

NPI 1053820530

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

18 Historical Events
📍
Updated Practice Location September 05, 2023

Registered at 225 CARLTON DAVIDSON LN, COAL GROVE, OH 456382924 (Tel: 7405330648)

📍
Updated Business Mailing Address September 05, 2023

Registered at 901 WASHINGTON ST, PORTSMOUTH, OH 456623944 (Tel: 7403547702)

📍
Updated Practice Location June 20, 2023

Registered at 700 PARK AVE, IRONTON, OH 456381502 (Tel: 7405321613)

📍
Updated Business Mailing Address June 20, 2023

Registered at PO BOX 108, IRONTON, OH 456380108 (Tel: 7405321613)

👤
Provider Name / Credentials Updated June 20, 2023

Recorded as PATRICK KELLEY, LCDCIII, QMHS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 20, 2023

Counselor (License #LCDCIII.162407 in OH)

📍
Updated Practice Location February 08, 2022

Registered at 117 N 4TH ST, IRONTON, OH 456381403 (Tel: 7402374981)

📍
Updated Business Mailing Address February 08, 2022

Registered at 117 N 4TH ST, IRONTON, OH 456381403 (Tel: 7402374981)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 08, 2022

Case Manager/Care Coordinator

📍
Updated Practice Location July 30, 2019

Registered at 103 2ND AVE, CHESAPEAKE, OH 456191134 (Tel: 7404510434)

👤
Provider Name / Credentials Updated July 30, 2019

Recorded as PATRICK KELLEY, CDCA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 30, 2019

Counselor (License #CDCA.171119 in OH)

✅
NPI Profile Active April 23, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location April 23, 2018

Registered at 1546 COUNTY ROAD 31, CHESAPEAKE, OH 456198073 (Tel: 7404510434)

📍
Updated Business Mailing Address April 23, 2018

Registered at 2239 BARBEQUE RD, CATLETTSBURG, KY 411291215

👤
Provider Name / Credentials Updated April 23, 2018

Recorded as PATRICK KELLEY

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 23, 2018

Case Manager/Care Coordinator

🟢
Initial NPI Registration & Enumeration April 23, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1659868941
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 23, 2018
Last Update: September 05, 2023
Sole Proprietor: No
Update or Correct Profile

Mailing Address

901 Washington St

Portsmouth, OH 456623944

Phone: 7403547702

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.