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KELLY LYNN MCKIBBEN RADT
NPI 1144960543
Counselor - Addiction (Substance Use Disorder) in Trabuco Canyon, CA

Active since April 01, 2022
20331 FLANAGAN ROAD, TRABUCO CANYON, CA 92679(818) 582-8832(818) 582-8836 Get Directions Write a Review

NPPES record last updated: July 1, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly Lynn Mckibben Radt NPPES

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

KELLY LYNN MCKIBBEN RADT (NPI 1144960543) is an individual addiction (substance use disorder) provider in Trabuco Canyon, California, licensed in California (R1439310721) and active in the NPI registry since April 2022.

NPPES Registry Identity

NPI1144960543
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameKELLY LYNN MCKIBBENCredential: RADT
Location Address20331 FLANAGAN ROADTrabuco Canyon, CA 92679
Mailing Address5392 Sierra Roja RdIrvine, CA 92603-3828 · (949) 350-5202
Phone(818) 582-8832
Fax(818) 582-8836
Sole ProprietorNo
Enumeration DateApril 1, 2022
Last NPPES UpdateJuly 1, 2022
NPPES CertifiedJuly 1, 2022
✔ NPI 1144960543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · R1439310721
20331 FLANAGAN ROAD, Trabuco Canyon, CA 92679
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JOHN PAUL ZUNIGA RADT
Counselor (Addiction (Substance Use Disorder))
20331 FLANAGAN ROAD
TRABUCO CANYON, CA 92679
Orange County (818) 582-8832
MS. GINA REIGH FRAGA RADT
Counselor (Addiction (Substance Use Disorder))
20331 FLANAGAN ROAD
TRABUCO CANYON, CA 92679
Orange County (818) 582-8832
LYNN MARIE NYHUS RADT
Counselor (Addiction (Substance Use Disorder))
20331 FLANAGAN ROAD
TRABUCO CANYON, CA 92679
Orange County (818) 582-8832
KELSEY FREDENBERG
Social Worker
20331 FLANAGAN ROAD
TRABUCO CANYON, CA 92679
Orange County (818) 582-8832
MS. YOLITA HENDRICKS RADT
Counselor (Addiction (Substance Use Disorder))
20331 FLANAGAN ROAD
TRABUCO CANYON, CA 92679
Orange County (818) 582-8832
DAISY RAMIREZ
Counselor (Addiction (Substance Use Disorder))
20331 FLANAGAN ROAD
TRABUCO CANYON, CA 92679
Orange County (818) 582-8832
ATLANTA DANIELLE ST.MARTIN RADT
Counselor (Addiction (Substance Use Disorder))
20331 FLANAGAN ROAD
TRABUCO CANYON, CA 92679
Orange County (818) 582-8832
MYKAYLA SWANSON
Counselor (Addiction (Substance Use Disorder))
20331 FLANAGAN ROAD
TRABUCO CANYON, CA 92679
Orange County (818) 582-8832

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 Mckibben's NPI number?

The NPI number for Kelly Mckibben is 1144960543. It was assigned to this individual provider in the NPPES registry on April 1, 2022.

Where is Kelly Mckibben located?

Kelly Mckibben practices at 20331 Flanagan Road, Trabuco Canyon, CA 92679. The listed phone number is (818) 582-8832.

What is Kelly Mckibben's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kelly Mckibben was last updated on July 1, 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.