JACQUELINE KELLY-FADDLER MS, LPCC
NPI 1881020527
Counselor - Professional in Princeton, MN

Active since September 25, 2013PECOS Enrolled
501 4TH ST S STE 201, PRINCETON, MN 55371(763) 498-1822 Get Directions Write a Review

NPPES record last updated: May 2, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 2, 2022, May 16, 2018 (2 updates tracked since 2018).

About Jacqueline Kelly-faddler Ms, Lpcc NPPES

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

JACQUELINE KELLY-FADDLER MS, LPCC (NPI 1881020527) is an individual professional provider in Princeton, Minnesota, licensed in Minnesota (842) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1881020527
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJACQUELINE KELLY-FADDLERCredential: MS, LPCC
Location Address501 4TH ST S STE 201Princeton, MN 55371-4754
Mailing Address501 4th St S Ste 201Princeton, MN 55371-4754 · (763) 482-1185
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateSeptember 25, 2013
Last NPPES UpdateMay 2, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 29, 2021
NPI 1881020527 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 MN · 842
501 4TH ST S STE 201, Princeton, MN 55371

Other Names 1

Former Name (1)Jacqueline Faddler

Other Identifiers 1

Medicaid1881020527MN

Accepted 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)

Jacqueline Kelly-faddler Ms, Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476097098
PECOS Enrollment IDI20240706000216
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.

Other Providers at the Same Location NPPES 3

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

Marriage & Family Therapist
501 4TH ST S STE 201
PRINCETON, MN 55371
Counselor (Mental Health)
501 4TH ST S STE 201
PRINCETON, MN 55371
Counselor (Professional)
501 4TH ST S STE 201
PRINCETON, MN 55371

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 Jacqueline Kelly-faddler's NPI number?

The NPI number for Jacqueline Kelly-faddler is 1881020527. It was assigned to this individual provider in the NPPES registry on September 25, 2013. The provider is also known as Jacqueline Faddler.

Where is Jacqueline Kelly-faddler located?

Jacqueline Kelly-faddler practices at 501 4th St S Ste 201, Princeton, MN 55371. The listed phone number is (763) 498-1822.

What is Jacqueline Kelly-faddler's specialty?

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

Is Jacqueline Kelly-faddler enrolled in Medicare?

Yes. Jacqueline Kelly-faddler is registered in the Medicare PECOS enrollment system.

What insurance does Jacqueline Kelly-faddler accept?

Health plans from HealthPartners list Jacqueline Kelly-faddler 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 Jacqueline Kelly-faddler was last updated on May 2, 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.