Individual provider Active NPI

Jennifer M Pelkey, MS

  • Mental Health Counselor
  • Pawtucket, RI
National Provider Identifier
1033607072
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHC01166 Issued in RI
Practice address
249 Roosevelt Ave
Pawtucket, RI 02860-2134
Phone
(401) 724-8400
NPI assigned
Apr 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MHC01166 RI Primary

Addresses

Primary practice location

249 Roosevelt Ave
Pawtucket, RI 02860-2134

Mailing address

249 Roosevelt Ave
Pawtucket, RI 02860-2134
Phone (401) 724-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20251215001755 RI Practitioner - Mental Health Counselor 9931693165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MHC01166RIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychiatry, Inc. Mental Health CurrentSince Oct 6, 2025 Accepting new patients

Locations

1035 Post Rd
Warwick, RI 02888
Phone (401) 941-2830

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.jenniferpelkey@151046.advancedmd-direct.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1033607072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 ROOSEVELT AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028602134",
            "telephone_number": "401-724-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 ROOSEVELT AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028602134",
            "telephone_number": "401-724-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELKEY",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC01166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.