KELLEY F EVERSON LPC
NPI 1053685602
Counselor - Professional in Janesville, WI
About Kelley F Everson Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLEY F EVERSON LPC (NPI 1053685602) is an individual professional provider in Janesville, Wisconsin, licensed in Wisconsin (4673-125) and active in the NPI registry since February 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2004).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kelley F Everson Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kelley Everson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Beloit, WI 53511
- Reassigned Medicare billing, Wisconsin enrollment
- 34 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
JANESVILLE, WI 53548
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 Kelley Everson's NPI number?
The NPI number for Kelley Everson is 1053685602. It was assigned to this individual provider in the NPPES registry on February 29, 2012.
Where is Kelley Everson located?
Kelley Everson practices at 17 S River St 254, Janesville, WI 53548. The listed phone number is (608) 755-5260.
What is Kelley Everson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Kelley Everson enrolled in Medicare?
Yes. Kelley Everson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kelley Everson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelley Everson reassigns Medicare benefits to Stateline Mental Health Services (Beloit, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelley Everson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelley Everson accept?
Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan, Group Health Cooperative-SCW, MercyCare and MercyCare Health Plans and 2 other insurers list Kelley Everson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kelley Everson was last updated on February 29, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.
# Kelley F Everson, LPC · NPI 1053685602
Professional provider in Janesville, Wisconsin. Individual provider, active in the CMS NPPES registry since February 29, 2012.
## Identity
- **NPI:** 1053685602 (Entity type: Individual)
- **Enumerated:** February 29, 2012
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 4673-125 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 17 S RIVER ST, 254, Janesville, WI 53548-3860
- **Phone:** (608) 755-5260 · **Fax:** (608) 755-5267
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Stateline Mental Health Services (NPI 1538560255, Beloit, WI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2004
## Record status
- **NPPES last updated:** February 29, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1053685602) · Data from the CMS NPPES public registry.