MEDICARE: MEGAN PAIGE KELLY MA, LMHCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	88001149A	IN
2	101Y00000X	Counselor	6401225787	MI

General Provider Information

NPI Number	:	1649944588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN PAIGE KELLY MA, LMHCA

Provider Business Mailing Address
First Line	:	800 MONROE AVE NW STE 202
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-1448
Country	:	US
Telephone Number	:	612-442-2313
Fax Number	:

Provider Business Practice Location Address
First Line	:	9783 E 116TH ST
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46037-2822
Country	:	US
Telephone Number	:	260-799-1447
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2021
Last Update Date	:	03/19/2026

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