Tara Marie Kellogg

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MT2003 Issued in FL

Practice address

3521 W Broward Blvd
3Rd Floor
Ft Lauderdale, FL 33312-1048

Phone

(954) 587-1008

Fax

(954) 587-0080

NPI assigned

Sep 10, 2008

Last updated

Sep 10, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vytalyze Minds, CorpGroup PAC ID 3779972583, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vytalyze Minds Corp D/B/a Vertex Health

  dba Vertex Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hialeah, FL
  • NPI 1588275150
  Medicare reassignment Care Compare group NPD
• The Luminescent Mind, LLC

  • Mental Health Counselor
  • St Petersburg, FL
  • NPI 1023704947
  Medicare reassignment
• Vytalyze Minds Corp D/B/a Vertex Health

  dba Vertex Health

  • Behavior Analyst
  • Hialeah, FL
  • NPI 1770218554
  NPD
• Chrysalis Center, LLC

  dba Chrysalis Health

  • Community/Behavioral Health Agency
  • Fort Lauderdale, FL
  • NPI 1700961646
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1023267416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 W BROWARD BLVD",
            "address_2": "3RD FLOOR",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333121048",
            "telephone_number": "954-587-1008",
            "fax_number": "954-587-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 W BROWARD BLVD",
            "address_2": "3RD FLOOR",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333121048",
            "telephone_number": "954-587-1008",
            "fax_number": "954-587-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT2003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hubert T. Kebreau, OPTICIAN
• Keep Growing LLC
• Georgette Joedale Keldo
• Kimberly Kelleher, LMHC
• William Kelley
• Kelly Rashid Rd LLC
• Donald W Kelly, LMHC
• Kathleen Kelly, MSW, LCSW
• Kerry Kathleen Kelly, ARNP
• Katrina Schiefer Kemos, LCSW

• Marriage & Family Therapist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.