KELLY SUE PACHECO- GAGNER M.S., LPCC
NPI 1437661402
Counselor - Professional in Los Angeles, CA

Q: What is Kelly Pacheco- Gagner's NPI number?

The NPI number for Kelly Pacheco- Gagner is 1437661402. It was assigned to this individual provider in the NPPES registry on October 31, 2017. The provider is also known as Kelly Pacheco-Gagner M.S., Lpcc.

Q: What is Kelly Pacheco- Gagner's specialty?

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

Active since October 31, 2017PECOS EnrolledAccepts Medicare Assignment

6200 WILSHIRE BLVD STE 1410, LOS ANGELES, CA 90048(925) 282-1778 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 30, 2019, Oct 31, 2017 (2 updates tracked since 2017).

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About Kelly Sue Pacheco- Gagner M.s., Lpcc NPPES

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

KELLY SUE PACHECO- GAGNER M.S., LPCC (NPI 1437661402) is an individual professional provider in Los Angeles, California, licensed in California (17859) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1437661402

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameKELLY SUE PACHECO- GAGNERCredential: M.S., LPCC

Location Address6200 WILSHIRE BLVD STE 1410Los Angeles, CA 90048-5815

Mailing Address6200 Wilshire Blvd Ste 1410Los Angeles, CA 90048-5815 · (925) 282-1778

Phone(925) 282-1778

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateOctober 31, 2017

Last NPPES UpdateApril 22, 20252 updates tracked since enumeration

NPPES CertifiedApril 22, 2025

✔ NPI 1437661402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

Licenses✔ Licensed in CA · 17859✔ Licensed in OR · C9686

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 17859 (CA)

6200 WILSHIRE BLVD STE 1410, Los Angeles, CA 90048

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Other Names 1

Professional Name (2)Kelly Pacheco-gagner M.s., Lpcc

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

Kelly Sue Pacheco- Gagner M.s., 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.

PECOS PAC ID2264958347

PECOS Enrollment IDI20250501001937

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.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Pacheco- Gagner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pacific Coast Psychiatric Associates Inc

372 mi

Clinical

7373 N SCOTTSDALE RD STE A199
Scottsdale, AZ 85253

Reassigned Medicare billing, California enrollment
766 clinicians in this Medicare group

NPI 1023125465 (702) 805-5360

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 20

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

RUFINA SANDOVAL LCSW

Social Worker (Clinical)