Individual provider Active NPI

Kelli Soranno, LCAT

  • Art Therapist
  • Riverhead, NY
National Provider Identifier
1114432630
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Art TherapistTaxonomy code 221700000X
License
002464 Issued in NY
Practice address
1380 Roanoke Avenue
Riverhead, NY 11901
Phone
(631) 369-0022
NPI assigned
Dec 6, 2017
Last updated
Dec 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Art Therapist 221700000X 002464 NY Primary

Addresses

Primary practice location

1380 Roanoke Avenue
Riverhead, NY 11901

Mailing address

565 Route 25a Ste 202
Miller Place, NY 11764-2665

Other practice location 1

565 Route 25A Ste 202
Miller Place, NY 11764-2665
Phone (631) 352-2864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
002464NYMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Youth Council Inc CurrentSince Jun 26, 2022 Accepting new patients

Locations

525 Route 25A
Rocky Point, NY 11778
Phone (631) 744-0207

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1114432630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 ROUTE 25A STE 202",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 ROANOKE AVENUE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "11901",
            "telephone_number": "631-369-0022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "565 Route 25A Ste 202",
            "address_purpose": "LOCATION",
            "city": "Miller Place",
            "state": "NY",
            "postal_code": "117642665",
            "country_code": "US",
            "telephone_number": "631-352-2864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SORANNO",
        "first_name": "KELLI",
        "credential": "LCAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "002464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.