Healthcare Provider Details

I. General information

NPI: 1932013794
Provider Name (Legal Business Name): KELSI WATSON PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3322 S CAMPBELL AVE
SPRINGFIELD MO
65807-4980
US

IV. Provider business mailing address

5305 S MICHIGAN AVE APT A103
SPRINGFIELD MO
65810-2943
US

V. Phone/Fax

Practice location:
  • Phone: 417-755-0942
  • Fax:
Mailing address:
  • Phone: 417-293-3423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2026044881
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: