Kayla Gail Anthony, MS, LPC, LMHC

Individual provider Active NPI Professional Counselor · Greenville, SC

NPI 1194196576 · NPPES record last updated Jan 3, 2024

Key facts

NPI
1194196576
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
9287 (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
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Ellie LLC (8 clinicians)

Practice addresses (Care Compare)

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240116004438 SC Practitioner - Mental Health Counselor 9739531658 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MH15643FLMDProfessional Counselor
9287SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Ellie LLC Current
since Jan 1, 2024
Accepting new patients

Locations

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

Specialties & licenses

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

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

Other providers in Greenville, SC

All providers in Greenville, SC · Professional Counselor in South Carolina

Sources for this page

Verify at the official NPI Registry.