MRS. KELLY JEAN HOLLINGSWORTH LPCC
NPI 1073255774
Counselor - Mental Health in Fairmont, MN
About Mrs. Kelly Jean Hollingsworth Lpcc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KELLY JEAN HOLLINGSWORTH LPCC (NPI 1073255774) is an individual mental health provider in Fairmont, Minnesota, licensed in Minnesota (3275) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2018).
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
Mrs. Kelly Jean Hollingsworth Lpcc 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 Kelly Hollingsworth reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Luverne, MN 56156
- Reassigned Medicare billing, Minnesota enrollment
- 33 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.
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 Kelly Hollingsworth's NPI number?
The NPI number for Kelly Hollingsworth is 1073255774. It was assigned to this individual provider in the NPPES registry on April 12, 2022.
Where is Kelly Hollingsworth located?
Kelly Hollingsworth practices at 1244 Albion Ave, Fairmont, MN 56031. The listed phone number is (507) 236-7568.
What is Kelly Hollingsworth's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Kelly Hollingsworth enrolled in Medicare?
Yes. Kelly Hollingsworth 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 Kelly Hollingsworth's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Hollingsworth reassigns Medicare benefits to Southwestern Mental Health Center Inc (Luverne, MN). 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 Kelly Hollingsworth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Hollingsworth accept?
Health plans from Avera Health Plans, Sanford Health Plan and Wellmark Health Plan of Iowa, Inc. list Kelly Hollingsworth 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 Kelly Hollingsworth was last updated on April 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Mrs. Kelly Jean Hollingsworth, LPCC · NPI 1073255774
Mental Health provider in Fairmont, Minnesota. Individual provider, active in the CMS NPPES registry since April 12, 2022.
## Identity
- **NPI:** 1073255774 (Entity type: Individual)
- **Enumerated:** April 12, 2022
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 3275 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 1244 ALBION AVE, Fairmont, MN 56031-3139
- **Phone:** (507) 236-7568
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Southwestern Mental Health Center Inc (NPI 1487654562, Luverne, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** April 12, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1073255774) · Data from the CMS NPPES public registry.