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MACUSHLA COLLEEN KELLY
NPI 1013897834
Counselor - Professional in Mound, MN

Active since September 03, 2025
4895 EDGEWATER DR, MOUND, MN 55364(612) 308-4309 Get Directions Write a Review

NPPES record last updated: September 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Macushla Colleen Kelly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MACUSHLA COLLEEN KELLY (NPI 1013897834) is an individual professional provider in Mound, Minnesota, licensed in Minnesota (CC00446) and active in the NPI registry since September 2025.

NPPES Registry Identity

NPI1013897834
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMACUSHLA COLLEEN KELLY
Location Address4895 EDGEWATER DRMound, MN 55364-2005
Mailing Address4895 Edgewater DrMound, MN 55364-2005
Phone(612) 308-4309
Sole ProprietorYes
Enumeration DateSeptember 3, 2025
NPPES CertifiedSeptember 3, 2025
✔ NPI 1013897834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MN · CC00446
4895 EDGEWATER DR, Mound, MN 55364
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Macushla Kelly's NPI number?

The NPI number for Macushla Kelly is 1013897834. It was assigned to this individual provider in the NPPES registry on September 3, 2025.

Where is Macushla Kelly located?

Macushla Kelly practices at 4895 Edgewater Dr, Mound, MN 55364. The listed phone number is (612) 308-4309.

What is Macushla Kelly's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Macushla Kelly was last updated on September 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.