KELLI BASTIAANSE – Mental Health Counselor, NPI 1730476870

KELLI BASTIAANSE is a healthcare provider. based in Bristol, Connecticut. specializing in MENTAL HEALTH COUNSELOR. The NPI Number for KELLI BASTIAANSE is 1730476870

Main info

Female
Sole Proprietor
25 Years Of Experience
Accepts Medicare Assignment
Name
KELLI BASTIAANSE
NPI
1730476870
Phone
(860) 331-1854
Address
29 WINDHAM RD
Enumeration Date
8 July 2011
Last Update Date
8 July 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2001 (25 years ago)
PAC ID
8426493255
Professional Enrollment ID
I20240301003052
Address ID
CT060102762BR29XXXRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:14State licenses:0Digital endpointsOther names

818 MENTAL HEALTH COUNSELOR in CT

Provider Addresses for KELLI BASTIAANSE

  • 29 WINDHAM RD

    BRISTOL, CT 060102762

    Phone: (860) 331-1854

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-03-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240301003052IMental Health CounselorCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06010)

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Reviews

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Frequently asked questions

What identifier follows KELLI BASTIAANSE across health systems?
The NPI 1730476870 uniquely identifies KELLI BASTIAANSE in U.S. healthcare data.
Should I treat KELLI BASTIAANSE as an active provider?
Patients and plans typically see KELLI BASTIAANSE as active in the national extract.
What does the directory say KELLI BASTIAANSE does?
Insurance directories may phrase it differently, but here KELLI BASTIAANSE maps to Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Can patients visit KELLI BASTIAANSE in Bristol, Connecticut?
For routing, start with Bristol, Connecticut for KELLI BASTIAANSE, then verify phone and hours locally.
Who maintains KELLI BASTIAANSE's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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