Holistic Health With Kelly LLC

Organization Active NPI Mental Health Counselor · Meridian, MS

NPI 1245806041 · NPPES record last updated Jun 2, 2021

Key facts

NPI
1245806041
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Counselor 101YM0800X
Legal business name
HOLISTIC HEALTH WITH KELLY LLC
Practice address
6259 Pinedale Rd
Meridian, MS 39305-3430
Phone
(601) 616-3752
NPI assigned
Jun 2, 2021
Organization subpart
No

Authorized official

Name
Kelly Harper Smith, LCSW
Title
Owner
Phone
(601) 616-3752

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210830002828 MS Part B Supplier - Clinic/Group Practice 1850797846 Receives reassigned benefits from 9 practitioners
Practice locations: Meridian, MS

National Provider Directory

Locations

2011 23rd Ave
Meridian, MS 39301
Phone (601) 286-5983

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YM0800X Yes

Addresses

Primary practice location

6259 Pinedale Rd
Meridian, MS 39305-3430

Mailing address

6259 Pinedale Rd
Meridian, MS 39305-3430
Phone (601) 616-3752

Other providers in Meridian, MS

All providers in Meridian, MS · Mental Health Counselor in Mississippi

Sources for this page

Verify at the official NPI Registry.