Active NPI
Kentaya Nielly, MS, LMHC
- Mental Health Counselor
- West Park, FL
National Provider Identifier
1154942688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 4112 SW 27TH St
West Park, FL 33023-4466 - Phone
- (954) 445-5622
- NPI assigned
- May 6, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
4112 SW 27TH St
West Park, FL 33023-4466
Mailing address
4112 SW 27TH St
West Park, FL 33023-4466
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keys 2 Epiphany LLC | Current | Accepting new patients | |
| Family Counseling Associates of North Georgia LLC | Professional | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Atlanta, GA
- NPI 1841174836
-
- Professional Counselor
- Cumming, GA
- NPI 1861645376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588723200000",
"number": "1154942688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4112 SW 27TH ST",
"city": "WEST PARK",
"state": "FL",
"postal_code": "330234466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4112 SW 27TH ST",
"city": "WEST PARK",
"state": "FL",
"postal_code": "330234466",
"telephone_number": "954-445-5622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELLY",
"first_name": "KENTAYA",
"credential": "MS, LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-06",
"last_updated": "2020-05-06",
"certification_date": "2020-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.