KELLY LYNN OTTAWAY
NPI 1154861581
Counselor - Professional in Jackson, MI

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YP2500X and a focus in Professional.

Active since March 04, 2017PECOS Enrolled

207 1ST ST, JACKSON, MI 49201(517) 998-4673 Get Directions Write a Review

NPPES record last updated: October 16, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Kelly Lynn Ottaway NPPES

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

KELLY LYNN OTTAWAY (NPI 1154861581) is an individual professional provider in Jackson, Michigan, licensed in Michigan (6401018105) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154861581

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameKELLY LYNN OTTAWAY

Location Address207 1ST STJackson, MI 49201-2102

Mailing Address407 W Harrison StWakarusa, IN 46573-9583 · (226) 787-1217

Phone(517) 998-4673

Sole ProprietorYes

Enumeration DateMarch 4, 2017

Last NPPES UpdateOctober 16, 2024

NPPES CertifiedOctober 16, 2024

✔ NPI 1154861581 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 MI · 6401018105

207 1ST ST, Jackson, MI 49201

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Lynn Ottaway is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.