Individual provider Active NPI

Kayla Gail Anthony, MS, LPC, LMHC

  • Professional Counselor
  • Greenville, SC
National Provider Identifier
1194196576
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
9287 Issued in SC
Practice address
430 Woodruff Rd Ste 450
Greenville, SC 29607-3443
Phone
(864) 400-5130
Fax
(864) 818-4697
NPI assigned
Oct 12, 2015
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X MH15643 FL
Professional Counselor 101YP2500X 9287 SC Primary

Addresses

Primary practice location

430 Woodruff Rd Ste 450
Greenville, SC 29607-3443

Mailing address

430 Woodruff Rd Ste 450
Greenville, SC 29607-3443
Phone (864) 400-5130

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3001
Phone (352) 627-9350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20240116004438 SC Practitioner - Mental Health Counselor 9739531658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Ellie LLCGroup PAC ID 3577938224, 8 clinicians

Practice addresses (Care Compare)

430 Woodruff Rd
Suite 450
Greenville, SC 29607-3443
Phone (864) 400-5130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MH15643FLMDProfessional Counselor
9287SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Ellie LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

430 Woodruff Rd
Ste 450
Greenville, SC 29607
Phone (864) 400-5130

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": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1194196576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 WOODRUFF RD STE 450",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073443",
            "telephone_number": "864-400-5130",
            "fax_number": "864-818-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 WOODRUFF RD STE 450",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073443",
            "telephone_number": "864-400-5130",
            "fax_number": "864-818-4697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103001",
            "country_code": "US",
            "telephone_number": "352-627-9350",
            "fax_number": "352-294-8096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "KAYLA",
        "middle_name": "GAIL",
        "credential": "MS, LPC, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH15643",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "9287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.